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Pennsylvania rates for HCPCS 26121

Fasciectomy, palm only, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$686.59 / $3,589.00 / $8,113.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.39 / $603.91 / $1,450.32
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,150.00 / $7,463.00 / $11,091.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$607.89 / $639.92 / $1,088.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$688.92 / $688.92 / $688.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.67 / $732.85 / $1,215.43
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$720.78 / $973.11 / $1,244.98
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,853.46 / $7,164.13 / $10,652.29
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.16 / $624.61 / $780.78
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$686.59 / $3,888.35 / $8,247.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.38 / $671.46 / $1,992.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$958.10 / $958.10 / $1,235.80
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$688.92 / $688.92 / $688.92
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563.24 / $747.67 / $1,230.15
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$590.38 / $590.38 / $852.45
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$573.76 / $591.71 / $852.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $3,475.00 / $6,368.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530.72 / $730.28 / $1,187.33