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Pennsylvania rates for HCPCS A4257

Replacement lens shield cartridge for use with laser skin piercing device, each

Facilitymedian $13 · 10th–90th $8–$140%20%40%10th90th$13Professionalmedian $11 · 10th–90th $7–$160%20%40%10th90th$11$1.0$10.0$100.0$1.0K$10.0K

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
$7.94 / $10.00 / $13.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $10.96 / $15.14
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
$17.78 / $17.78 / $17.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $7.41 / $7.41
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $26.30 / $39.81
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $18.20
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $12.59 / $18.20
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.94 / $7.94 / $10.00
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $10.96 / $15.14
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $24.55 / $35.48
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $16.98
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $12.88 / $16.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $8.91 / $16.22