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Pennsylvania rates for HCPCS 27258

Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc);

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,155.24 / $3,964.00 / $8,509.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,001.55 / $1,126.58 / $1,630.74
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,296.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,115.22 / $1,202.85 / $2,040.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,260.32 / $1,260.32 / $1,260.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,052.08 / $1,349.57 / $2,244.82
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,315.51 / $1,784.56 / $2,272.25
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,424.89 / $14,424.89 / $15,291.45
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,268.00 / $8,268.00 / $8,268.00
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,155.24 / $4,761.00 / $9,211.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,001.55 / $1,250.20 / $5,482.44
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,363.90 / $1,363.90 / $2,264.69
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,260.32 / $1,260.32 / $1,260.32
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,052.08 / $1,380.00 / $2,311.44
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,087.23 / $1,087.23 / $1,214.96
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,051.82 / $1,094.64 / $1,214.96
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
$1,018.11 / $1,349.93 / $2,108.25