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Pennsylvania rates for HCPCS 40650

Repair Lip Full Thickness Vermilion Only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$468.77 / $1,758.00 / $6,459.00
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$248.54 / $248.54 / $389.23
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.69 / $3,159.00 / $14,886.03
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$780.88 / $1,243.29 / $2,566.57
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.29 / $2,622.20 / $7,263.00
Martin's Point
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$248.54 / $248.54 / $389.23
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.13 / $537.13 / $537.13
Priority Health
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$375.99 / $375.99 / $375.99
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$306.69 / $324.68 / $466.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.00 / $650.00 / $4,300.00