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Pennsylvania rates for HCPCS 40801

Drg Absc Cst Hmtma Vestibule Mouth Comp

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.32 / $2,747.00 / $8,017.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.26 / $274.83 / $441.67
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.69 / $3,159.00 / $14,886.03
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.81 / $299.70 / $299.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.02 / $323.70 / $555.46
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.30 / $459.87 / $472.98
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,383.06 / $1,383.06 / $1,383.06
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$918.00 / $3,077.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.04 / $307.39 / $1,056.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $233.20 / $770.30
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.64 / $327.97 / $565.07
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.96 / $238.88 / $332.87
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.20 / $276.19 / $301.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.00 / $557.00 / $3,742.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.99 / $359.70 / $585.73