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Pennsylvania rates for HCPCS 84081

Phosphatidylglycerol

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.38 / $44.92 / $69.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.89 / $13.55 / $68.23
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.31 / $108.18 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.89 / $12.89 / $12.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.86 / $22.00 / $54.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.41 / $19.00 / $28.77
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.60 / $9.75 / $22.37
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.04 / $44.92 / $69.09
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.78 / $14.04 / $68.23
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.06 / $25.10 / $54.33
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.41 / $19.00 / $28.77
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.52 / $16.52 / $16.52
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.54 / $16.52 / $23.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.43 / $10.57 / $28.94