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Pennsylvania rates for HCPCS 55250

Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.43 / $3,697.58 / $8,566.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$219.42 / $419.71 / $1,041.11
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$522.48 / $715.56 / $23,267.55
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,450.00 / $5,951.00 / $8,887.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.05 / $357.37 / $1,219.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.54 / $400.51 / $686.65
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.00 / $438.75 / $518.62
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,447.48 / $4,326.97 / $7,715.97
Independence Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$480.68 / $728.81 / $7,686.03
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$381.44 / $3,867.17 / $8,449.50
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.62 / $436.21 / $1,007.19
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $518.79 / $887.70
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.07 / $391.76 / $745.15
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$222.28 / $323.77 / $605.01
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.25 / $317.62 / $390.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,175.00 / $2,824.00 / $4,789.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.97 / $464.06 / $754.96