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Pennsylvania rates for HCPCS 97597

Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; first 20 sq cm or less

Facilitymedian $372 · 10th–90th $83–$2,3440%5%10%10th90th$372Professionalmedian $78 · 10th–90th $28–$2000%10%10th90th$78$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
Typical Low / Median / Typical High
$83.18 / $371.54 / $2,344.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $77.62 / $199.53
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $50.12 / $95.50
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $3,715.35
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $33.88 / $77.62
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $107.15 / $151.36
Capital Blue Cross
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$97.72 / $134.90 / $165.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $54.95 / $123.03
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $158.49 / $173.78
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $109.65 / $165.96
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $398.11 / $707.95
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $91.20 / $100.00
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $6,165.95
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $26.30 / $48.98
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $478.63 / $4,265.80
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $75.86 / $181.97
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $323.59 / $416.87
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $131.83 / $309.03
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $34.67 / $97.72
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $34.67 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $616.60 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $56.23 / $104.71