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Pennsylvania rates for HCPCS 53405

Urethroplasty 2nd Stage W/Urinary Diversion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$930.82 / $2,747.00 / $8,017.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$773.16 / $880.41 / $1,108.41
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$872.77 / $905.71 / $905.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$841.77 / $1,126.63 / $1,771.22
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,016.65 / $1,345.13 / $1,350.05
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$934.00 / $3,120.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$773.16 / $930.82 / $2,843.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $1,119.20 / $2,165.00
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.54 / $1,137.65 / $1,815.25
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.98 / $847.98 / $1,065.94
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$822.32 / $852.08 / $1,065.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $3,475.00 / $6,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$854.88 / $1,068.23 / $1,767.28