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Pennsylvania rates for HCPCS A4617

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Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.12 / $2.12 / $3.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $2.12 / $3.58
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.17 / $3.03 / $7.05
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.82 / $4.33 / $4.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $1.77 / $3.21
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.11 / $4.33 / $6.50
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.92 / $2.92 / $3.25
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.12 / $2.12 / $3.37
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.27 / $2.12 / $6.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.40 / $6.50 / $8.50
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.76 / $6.76 / $6.76
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $1.77 / $4.88
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.10 / $4.12 / $4.12
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.10 / $4.12 / $4.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.65 / $2.16 / $3.90