go back

Pennsylvania rates for HCPCS 49905

Omental flap, intra-abdominal (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $5,754.40 / $8,511.38
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,417.38 / $21,379.62 / $57,543.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $602.56 / $870.96
Cigna
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$371.54 / $371.54 / $371.54
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$60.26 / $60.26 / $60.26
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $707.95 / $707.95
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,760.83 / $6,760.83 / $6,760.83
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $4,786.30 / $8,511.38
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $512.86 / $707.95
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $346.74 / $1,479.11
UPMC Health Plan
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$346.74 / $346.74 / $346.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $3,715.35 / $7,079.46