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Pennsylvania rates for HCPCS 42961

Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, requiring hospitalization

Facilitymedian $4,786 · 10th–90th $617–$8,5110%10%10th90th$4,786$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
$616.60 / $4,786.30 / $8,709.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20,417.38 / $21,379.62 / $57,543.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $707.95 / $870.96
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $6,025.60 / $8,317.64
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $1,584.89 / $8,317.64
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $407.38 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $2,511.89 / $6,165.95