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Pennsylvania rates for HCPCS 76642

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Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.05 / $229.36 / $475.57
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$28.98 / $35.81 / $65.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.56 / $94.71 / $417.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.35 / $41.75 / $144.00
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$67.84 / $189.99 / $646.50
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$43.11 / $54.25 / $238.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.17 / $65.45 / $85.32
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$24.35 / $30.99 / $53.72
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$76.23 / $94.60 / $104.79
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$64.23 / $77.59 / $77.90
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.96 / $1,386.63 / $2,371.50
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.72 / $107.23 / $138.69
AmeriHealth
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.96 / $39.82 / $95.72
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.20 / $135.04 / $159.31
Capital Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$35.60 / $52.71 / $63.98
Capital Blue Cross
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$135.30 / $202.56 / $238.98
Capital Blue Cross
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$54.61 / $81.13 / $95.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.70 / $137.94 / $260.37
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$37.03 / $37.03 / $37.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.81 / $108.86 / $168.01
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.09 / $42.82 / $65.42
Cigna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$113.75 / $113.75 / $129.22
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$41.70 / $67.02 / $103.03
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.67 / $117.11 / $201.28
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.95 / $47.25 / $74.05
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$62.34 / $80.15 / $127.23
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.82 / $195.69 / $350.96
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.42 / $97.87 / $112.37
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$36.01 / $40.53 / $56.83
Highmark BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$55.26 / $61.63 / $168.55
Highmark BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$67.56 / $67.56 / $93.03
Independence Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.71 / $1,117.67 / $2,371.50
Independence Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.72 / $107.23 / $138.69
Independence Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.96 / $39.82 / $95.72
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.50 / $223.60 / $529.16
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$28.98 / $41.12 / $93.79
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.00 / $103.00 / $360.11
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$28.98 / $46.42 / $122.26
Martin's Point
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$67.84 / $162.43 / $646.50
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$45.67 / $60.46 / $160.13
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.82 / $340.10 / $460.88
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.65 / $50.60 / $143.53
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.52 / $133.30 / $260.37
Priority Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$37.03 / $37.03 / $37.03
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.29 / $107.61 / $168.01
Priority Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$26.58 / $42.82 / $65.42
Priority Health
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$113.75 / $113.75 / $129.22
Priority Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$42.56 / $66.42 / $100.19
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.44 / $82.44 / $94.12
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$32.18 / $32.18 / $37.82
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.30 / $82.44 / $94.12
UPMC Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$31.33 / $32.21 / $37.82
UPMC Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$49.19 / $50.26 / $56.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.66 / $91.66 / $91.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.34 / $95.16 / $159.37
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.86 / $36.47 / $62.64
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$41.14 / $58.73 / $100.83