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Pennsylvania rates for HCPCS 66984

Xcapsl Ctrc Rmvl Insj Io Lens Prosth W/O Ecp

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,776.00 / $4,192.07 / $8,247.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,822.98 / $2,822.98 / $6,645.16
Aetna
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$105.20 / $116.48 / $116.48
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$436.81 / $436.81 / $8,676.36
Aetna
Facility/Professional
Facility
Modifier
55
Low / Median / High Price
$78.90 / $87.36 / $87.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$507.67 / $652.73 / $1,830.93
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$2,163.60 / $4,329.68 / $4,329.68
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$260.37 / $291.20 / $407.14
Aetna
Facility/Professional
Professional
Modifier
54
Low / Median / High Price
$380.75 / $458.51 / $646.97
Aetna
Facility/Professional
Professional
Modifier
55
Low / Median / High Price
$76.15 / $87.36 / $122.14
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$465.91 / $544.71 / $1,001.96
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,698.54 / $7,699.72 / $24,551.80
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.70 / $662.78 / $1,231.65
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,092.00 / $8,639.91 / $11,331.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.04 / $831.22 / $1,509.27
Capital Blue Cross
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$796.56 / $1,255.80 / $2,263.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,051.00 / $1,051.00 / $1,051.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.83 / $676.32 / $1,153.44
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$528.00 / $720.00 / $836.00
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,686.69 / $4,307.70 / $7,598.69
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$617.49 / $734.82 / $1,063.54
Highmark BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$1,484.27 / $1,484.27 / $1,484.27
Highmark BCBS
Facility/Professional
Professional
Modifier
54
Low / Median / High Price
$430.64 / $457.24 / $523.49
Highmark BCBS
Facility/Professional
Professional
Modifier
55
Low / Median / High Price
$122.58 / $132.37 / $163.59
Independence Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,616.39 / $7,612.64 / $15,620.28
Independence Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.70 / $623.79 / $1,231.65
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.30 / $4,758.47 / $8,734.71
Martin's Point
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,822.98 / $2,822.98 / $6,645.16
Martin's Point
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$116.48 / $116.48 / $116.48
Martin's Point
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$436.81 / $8,676.36 / $8,676.36
Martin's Point
Facility/Professional
Facility
Modifier
55
Low / Median / High Price
$87.36 / $87.36 / $87.36
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$521.74 / $671.31 / $2,670.12
Martin's Point
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$2,163.60 / $2,163.60 / $4,329.68
Martin's Point
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$260.37 / $309.91 / $706.87
Martin's Point
Facility/Professional
Professional
Modifier
54
Low / Median / High Price
$390.56 / $486.80 / $650.04
Martin's Point
Facility/Professional
Professional
Modifier
55
Low / Median / High Price
$78.11 / $92.97 / $130.01
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,917.87 / $1,981.80 / $5,549.44
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$658.29 / $863.60 / $1,191.20
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,051.00 / $1,051.00 / $1,051.00
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$439.41 / $654.98 / $1,176.26
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$521.74 / $521.74 / $942.50
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$511.11 / $521.74 / $942.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,175.00 / $2,715.00 / $4,815.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.63 / $649.58 / $1,041.09