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Pennsylvania rates for HCPCS 61559

Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining grafts)

Facilitymedian $5,370 · 10th–90th $1,047–$8,5110%10%20%10th90th$5,370Professionalmedian $2,399 · 10th–90th $1,905–$4,5710%20%40%10th90th$2,399$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
$1,047.13 / $5,370.32 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,398.83 / $4,570.88
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
$3,715.35 / $3,715.35 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $2,818.38 / $4,677.35
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $4,265.80
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $3,162.28 / $4,466.84
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $4,265.80 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,398.83 / $3,801.89
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,162.28 / $4,466.84
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $2,398.83
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,238.72 / $2,398.83 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $2,630.27 / $7,079.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,884.03 / $4,786.30