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Pennsylvania rates for HCPCS 49605

Repair of large omphalocele or gastroschisis; with or without prosthesis

Facilitymedian $5,370 · 10th–90th $1,288–$8,5110%10%10th90th$5,370Professionalmedian $5,248 · 10th–90th $4,266–$9,7720%20%10th90th$5,248$10.0$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
$1,412.54 / $5,370.32 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $5,128.61 / $9,549.93
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20,417.38 / $21,379.62 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,918.31 / $7,585.78 / $7,585.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $794.33 / $8,317.64
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,235.94 / $5,623.41 / $10,000.00
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,232.93 / $10,232.93 / $10,232.93
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $6,760.83 / $9,120.11
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $5,128.61 / $7,943.28
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $4,265.80 / $8,511.38
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $5,128.61 / $8,317.64
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,778.28
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $8,511.38 / $10,715.19
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,786.30
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,786.30 / $5,011.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $2,290.87 / $6,309.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $5,495.41 / $9,549.93