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Pennsylvania rates for HCPCS 64755

Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $5,754.40 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $954.99 / $2,089.30
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,417.38 / $21,379.62 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,318.26 / $1,412.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $1,584.89 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,122.02 / $1,819.70
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,380.38 / $1,778.28
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,096.48 / $1,737.80
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $4,265.80 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,230.27 / $2,754.23
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,862.09
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,288.25 / $1,949.84
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $1,047.13 / $1,905.46
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $1,047.13 / $1,905.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $2,570.40 / $6,760.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,096.48 / $1,737.80