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Pennsylvania rates for HCPCS A4623

Tracheostomy Inner Cannula. (Rvsd 1/1/04) Ecial Coverage Instructions Apply. See Cim: 65-16)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.49 / $4.49 / $7.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.58 / $4.54 / $6.45
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.45 / $5.45 / $5.72
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
$6.98 / $9.16 / $9.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.50 / $5.50 / $9.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.68 / $4.68 / $6.79
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.43 / $9.16 / $17.39
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.18 / $6.18 / $6.87
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.49 / $4.49 / $7.12
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.50 / $4.71 / $7.12
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.80 / $12.50 / $18.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.50 / $5.50 / $9.57
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.68 / $4.68 / $10.50
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.54 / $8.72 / $8.72
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.54 / $8.72 / $8.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.04 / $4.57 / $8.26