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Pennsylvania rates for HCPCS 21196

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Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,468.95 / $3,589.00 / $8,451.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,291.47 / $1,422.05 / $2,279.59
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,296.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,415.53 / $1,468.95 / $1,468.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,599.88 / $1,599.88 / $1,599.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,335.41 / $1,769.62 / $2,869.26
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,656.12 / $2,197.84 / $2,860.56
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,086.51 / $24,138.59 / $57,744.56
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,286.00 / $4,642.80 / $9,534.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,291.47 / $1,515.38 / $3,995.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,492.20 / $1,492.20 / $3,055.90
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,599.88 / $1,599.88 / $1,599.88
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,354.58 / $1,788.68 / $3,000.91
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,397.64 / $1,397.64 / $1,485.34
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,364.75 / $1,397.64 / $1,485.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,332.00 / $3,879.00 / $7,508.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,276.05 / $1,720.55 / $2,869.73