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Pennsylvania rates for HCPCS 23455

Capsulorrhaphy, anterior; with labral repair (eg, Bankart procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,301.00 / $4,874.14 / $11,226.91
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,639.91 / $25,716.00 / $39,341.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,120.18 / $1,120.18 / $1,120.18
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,160.53 / $16,382.92 / $16,382.92
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,301.00 / $5,342.00 / $11,182.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,120.18 / $1,120.18 / $1,120.18
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$968.51 / $968.51 / $1,111.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,468.00 / $4,563.00 / $9,631.00