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Pennsylvania rates for HCPCS 42815

Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx

Facilitymedian $5,495 · 10th–90th $912–$10,7150%5%10%10th90th$5,495$1.0K$2.0K$5.0K$10.0K$20.0K$50.0K

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
$912.01 / $5,754.40 / $10,471.29
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $10,000.00 / $57,543.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $2,754.23 / $8,128.31
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $4,570.88 / $5,248.07
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $14,454.40 / $33,884.42
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $4,265.80 / $9,549.93
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $691.83
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $660.69 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $4,897.79 / $19,054.61