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Pennsylvania rates for HCPCS 42500

Plastic repair of salivary duct, sialodochoplasty; primary or simple

Facilitymedian $4,074 · 10th–90th $776–$8,3180%10%10th90th$4,074$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $4,073.80 / $8,317.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $7,585.78 / $57,543.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $4,168.69 / $8,128.31
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,570.88 / $5,248.07
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $11,748.98 / $26,302.68
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $3,630.78 / $7,244.36
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $380.19 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $3,311.31 / $19,054.61