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Blood Cleaning Through A Charcoal Filter

Pennsylvania rates for HCPCS 90997

A treatment in which blood is drawn out of the body, passed through a cartridge packed with a binding material such as activated charcoal, and returned. The material traps toxins that would otherwise stay in the bloodstream.

Rates data updated October 2026.

How much does Blood Cleaning Through A Charcoal Filter cost?

$93.33

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $93.33 for this service. The price depends on where it is billed: about $93.33 from a physician practice, and about $85.11 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$93.33$85.11 to $145
FacilityA hospital or hospital-owned outpatient department$85.11$85.11 to $93.33

How much rates vary

Facilitymedian $85 · 10th to 90th $85 to $5,012Professionalmedian $93 · 10th to 90th $83 to $178
$100$1K$10Kfacility $85professional $93

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$83.18
Median
$93.33
Typical High
$1,862.09
Aetna
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$85.11
Typical High
$93.33
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$41.69
Median
$42.66
Typical High
$46.77
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$16.60
Median
$16.98
Typical High
$18.62
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$12.59
Median
$12.88
Typical High
$13.80
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$8.32
Median
$8.51
Typical High
$9.33
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$141.25
Typical High
$181.97
Cigna
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$85.11
Typical High
$173.78
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$89.13
Median
$112.20
Typical High
$158.49
Geisinger
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$100.00
Typical High
$162.18
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$93.33
Median
$93.33
Typical High
$1,862.09
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$83.18
Median
$85.11
Typical High
$93.33
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$41.69
Median
$42.66
Typical High
$46.77
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$16.60
Median
$16.98
Typical High
$18.62
Martin's Point
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$12.59
Median
$12.88
Typical High
$13.80
Martin's Point
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$8.32
Median
$8.51
Typical High
$9.33
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$141.25
Median
$141.25
Typical High
$186.21
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$85.11
Median
$85.11
Typical High
$144.54
UPMC Health Plan
Setting
Professional
Modifier
None
Typical Low
$85.11
Median
$87.10
Typical High
$144.54
United
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$83.18
Typical High
$144.54

Where Pennsylvania sits

The same service costs 3.1 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 37th of 51

$93.33

AK $229FL $74.13

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.