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Pennsylvania rates for HCPCS 41872

Gingivoplasty Each Quadrant Specify

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$320.30 / $2,747.00 / $8,104.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.37 / $366.16 / $579.32
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,736.00 / $4,444.00 / $15,949.31
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$459.15 / $476.48 / $476.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$495.00 / $545.80 / $2,109.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.48 / $431.15 / $735.15
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$695.52 / $695.52 / $695.52
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$555.96 / $746.16 / $948.96
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$657.00 / $4,761.00 / $8,247.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.73 / $433.90 / $1,200.00
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.20 / $247.20 / $247.20
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $330.00 / $1,265.09
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$492.57 / $545.00 / $2,151.00
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.08 / $429.40 / $735.15
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.36 / $343.49 / $454.97
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.33 / $343.49 / $492.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,530.00 / $3,879.00 / $7,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.77 / $479.57 / $825.48