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Pennsylvania rates for HCPCS 43122

Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,301.00 / $3,839.00 / $8,113.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,316.78 / $2,542.73 / $3,279.95
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,296.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,554.98 / $2,651.41 / $2,651.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $800.00 / $2,910.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,229.40 / $3,147.38 / $5,377.44
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,720.88 / $5,720.88 / $5,720.88
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,077.41 / $3,933.05 / $5,115.68
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.00 / $4,761.00 / $8,247.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,237.31 / $2,695.55 / $8,005.78
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,204.69 / $2,204.69 / $2,204.69
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.00 / $2,957.10 / $6,334.50
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $800.00 / $2,910.22
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,230.31 / $3,133.49 / $5,377.44
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,478.08 / $2,478.08 / $2,702.55
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,373.80 / $2,519.12 / $2,702.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$388.00 / $2,020.00 / $6,322.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,230.31 / $3,017.47 / $4,913.72