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Pennsylvania rates for HCPCS 64809

Sympathectomy Thoracolumbar

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,020.00 / $2,747.00 / $8,247.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$864.58 / $1,003.05 / $1,499.22
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,296.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,102.45 / $1,144.06 / $1,979.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,249.74 / $1,249.74 / $1,249.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$807.60 / $1,206.72 / $2,123.09
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,323.58 / $1,864.17 / $2,286.17
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.00 / $4,761.00 / $8,427.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.00 / $1,142.32 / $5,464.90
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$945.70 / $945.70 / $2,207.69
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,249.74 / $1,249.74 / $1,249.74
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$874.80 / $1,236.01 / $2,123.09
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,019.45 / $1,072.24 / $1,072.24
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,019.45 / $1,072.24 / $1,140.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$448.00 / $2,391.00 / $6,322.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$920.37 / $1,278.61 / $2,133.92