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Pennsylvania rates for HCPCS 22101

Prtl Exc Pst Vrt Intrnsc B1y Les 1 Vrt Sgm Thrc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$898.09 / $3,066.00 / $7,799.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$765.47 / $856.91 / $1,412.91
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,393.00 / $11,479.00 / $18,724.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$896.46 / $930.29 / $1,662.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,017.00 / $1,017.00 / $1,017.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$763.76 / $1,044.49 / $1,745.13
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,073.42 / $1,485.04 / $1,854.10
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.00 / $3,839.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$771.45 / $965.80 / $4,253.72
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$872.50 / $872.50 / $1,806.50
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,017.00 / $1,017.00 / $1,017.00
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.21 / $1,063.16 / $1,753.34
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$734.96 / $849.97 / $849.97
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$734.96 / $849.97 / $904.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,468.00 / $4,563.00 / $9,631.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$762.04 / $1,033.36 / $1,784.93