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Pennsylvania rates for HCPCS 25101

Arthrt Wrst W/Jt Expl W/Wo Bx W/Wo Rmvl Loose/Fb

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$882.00 / $3,066.00 / $7,799.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$469.82 / $469.82 / $469.82
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.00 / $3,839.00 / $8,017.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$469.82 / $469.82 / $469.82
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$399.02 / $399.02 / $458.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $3,475.00 / $6,368.00