go back

Pennsylvania rates for HCPCS 43622

Gstrct Tot W/Frmj Intstinal Pouch Any Type

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
$2,027.20 / $2,304.91 / $2,990.65
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
$2,305.01 / $2,391.98 / $2,391.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $800.00 / $2,631.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,920.69 / $2,815.81 / $4,822.71
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,162.91 / $5,162.91 / $5,162.91
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,780.40 / $3,544.60 / $4,610.14
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
$1,996.76 / $2,461.51 / $7,310.68
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,731.30 / $1,731.30 / $1,731.30
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $2,316.10 / $5,773.90
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $800.00 / $2,631.54
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,976.56 / $2,771.01 / $4,822.71
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,748.78 / $2,256.62 / $2,256.62
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,748.78 / $2,256.62 / $2,370.63
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
$1,917.82 / $2,651.66 / $4,500.50