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Pennsylvania rates for HCPCS 22515

Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure)

Facilitymedian $2,692 · 10th–90th $372–$7,7620%5%10th90th$2,692Professionalmedian $1,820 · 10th–90th $204–$5,2480%10%10th90th$1,820$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $2,691.53 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $1,584.89 / $5,011.87
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,981.07 / $7,762.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $524.81 / $6,456.54
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $5,011.87 / $6,165.95
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $3,890.45 / $5,623.41
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,819.70
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $2,089.30 / $6,165.95
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $1,584.89 / $6,309.57
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $6,309.57
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $398.11 / $4,570.88
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $398.11 / $2,884.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $630.96 / $4,786.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $2,137.96 / $6,165.95