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Pennsylvania rates for HCPCS 91110

Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report

Facilitymedian $117 · 10th–90th $115$3550%50%10th90th$117Professionalmedian $741 · 10th–90th $126$1,7780%5%10%10th90th$741$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$114.82 / $117.49 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $977.24 / $3,388.44
Aetna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$107.15 / $186.21 / $575.44
Aetna
Facility/Professional
Professional
Modifier
52
Typical Low / Median / Typical High
$154.88 / $275.42 / $3,630.78
Aetna
Facility/Professional
Professional
Modifier
53
Typical Low / Median / Typical High
$426.58 / $1,698.24 / $1,698.24
Aetna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$575.44 / $741.31 / $1,288.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Ambetter
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$117.49 / $117.49 / $141.25
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $1,174.90
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $691.83 / $1,584.89
Capital Blue Cross
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$109.65 / $114.82 / $363.08
Capital Blue Cross
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$562.34 / $575.44 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,047.13 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$109.65 / $199.53 / $331.13
Cigna
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$602.56 / $851.14 / $1,479.11
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,148.15 / $1,380.38
Emblem Health
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$120.23 / $165.96 / $190.55
Emblem Health
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$724.44 / $1,000.00 / $1,174.90
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,023.29 / $1,659.59
Geisinger
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$123.03 / $186.21 / $323.59
Geisinger
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$660.69 / $831.76 / $1,412.54
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $977.24
Martin's Point
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$114.82 / $117.49 / $354.81
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $954.99 / $1,949.84
Martin's Point
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$109.65 / $162.18 / $316.23
Martin's Point
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$616.60 / $794.33 / $1,621.81
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,230.27 / $2,137.96
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$109.65 / $109.65 / $223.87
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $549.54 / $776.25
UPMC Health Plan
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$107.15 / $109.65 / $223.87
UPMC Health Plan
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$588.84 / $602.56 / $724.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $954.99 / $1,698.24
United
Facility/Professional
Professional
Modifier
26
Typical Low / Median / Typical High
$109.65 / $162.18 / $288.40
United
Facility/Professional
Professional
Modifier
TC
Typical Low / Median / Typical High
$602.56 / $812.83 / $1,445.44