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Pennsylvania rates for HCPCS 58263

Vag Hyst 250 Gm/< W/Rmvl Tube Ovary W/Rpr Ntrcl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,020.00 / $4,993.00 / $10,510.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,061.58 / $6,663.91 / $17,097.37
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,151.00 / $5,470.00 / $10,510.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$979.69 / $979.69 / $1,083.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $3,475.00 / $6,000.00