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Pennsylvania rates for HCPCS 22855

Removal Anterior Instrumentation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,157.75 / $4,680.00 / $9,676.00
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
$1,262.82 / $1,262.82 / $1,262.82
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$125.34 / $125.34 / $125.34
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,088.07 / $2,684.77 / $5,642.19
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,298.00 / $5,079.00 / $10,527.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,262.82 / $1,262.82 / $1,262.82
Priority Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$125.34 / $125.34 / $125.34
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,086.33 / $1,086.33 / $1,122.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,468.00 / $4,563.00 / $9,631.00