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Pennsylvania rates for HCPCS 96522

Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.69 / $120.57 / $194.04
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.00 / $111.03 / $205.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.43 / $140.59 / $230.86
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.74 / $172.61 / $225.77
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.59 / $132.13 / $206.96
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.40 / $176.93 / $333.80
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.15 / $139.07 / $236.06
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.53 / $110.44 / $141.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.42 / $125.33 / $204.45