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Pennsylvania rates for HCPCS 39501

Repair Laceration Diaphragm Any Approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$850.42 / $3,839.00 / $8,247.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,480.74
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,877.53 / $6,877.53 / $6,877.53
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$832.00 / $4,761.00 / $8,247.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$827.74 / $827.74 / $997.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$625.00 / $2,391.00 / $6,322.00