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Pennsylvania rates for HCPCS 22804

Arthrodesis Posterior Spinal Dfrm 13+ Vrt Sgm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,499.00 / $4,680.00 / $9,788.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,296.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,767.50 / $2,767.50 / $2,767.50
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,301.00 / $5,342.00 / $10,689.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,767.50 / $2,767.50 / $2,767.50
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,378.55 / $2,378.55 / $2,713.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,340.00 / $6,515.00 / $12,076.00