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Pennsylvania rates for HCPCS 96365

Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.40 / $108.05 / $381.32
Aetna
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$116.98 / $116.98 / $116.98
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.18 / $119.18 / $123.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.25 / $65.00 / $126.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.76 / $73.14 / $119.96
Independence Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.18 / $119.18 / $123.99
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.40 / $108.01 / $372.67
Martin's Point
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$116.98 / $116.98 / $116.98
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.76 / $91.19 / $119.96
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.83 / $60.83 / $109.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.73 / $84.59 / $129.16