go back

Pennsylvania rates for HCPCS 40700

Plstc Rpr Cl Lip/Nsl Dfrm Prim Prtl/Compl Uni

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,063.77 / $4,990.00 / $10,437.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$863.37 / $1,005.99 / $3,694.35
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,639.91 / $11,851.00 / $28,970.26
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,007.57 / $1,045.58 / $1,850.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$838.54 / $1,098.26 / $1,877.59
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,206.08 / $1,550.68 / $1,604.88
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,872.50 / $1,984.85 / $52,699.23
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,301.00 / $5,526.00 / $11,182.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$914.53 / $1,069.38 / $5,325.71
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,052.70 / $1,052.70 / $1,106.50
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,137.90 / $1,137.90 / $1,137.90
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$883.20 / $1,156.77 / $1,965.98
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.34 / $982.77 / $982.77
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$875.34 / $982.77 / $1,040.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,843.00 / $3,879.00 / $7,508.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$869.31 / $1,148.61 / $1,813.83