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Surgical Mask

Pennsylvania rates for HCPCS A4928

Surgical mask, per 20

Rates data updated October 2026.

How much does Surgical Mask cost?

$2.09

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $2.09 for this service. The price depends on where it is billed: about $2.09 from a physician practice, and about $1.26 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2.09$1.74 to $2.14
FacilityA hospital or hospital-owned outpatient department$1.26$1.26 to $5,012

How much rates vary

Facilitymedian $1 · 10th to 90th $1 to $56,234Professionalmedian $2 · 10th to 90th $1 to $17
$10$100$1K$10K$100Kfacility $1professional $2

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$1.26
Median
$1.26
Typical High
$1.26
Aetna
Setting
Professional
Modifier
None
Typical Low
$1.26
Median
$1.26
Typical High
$1.26
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$0.63
Median
$0.63
Typical High
$0.63
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$0.25
Median
$0.25
Typical High
$0.25
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.19
Median
$0.19
Typical High
$0.19
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.13
Median
$0.13
Typical High
$0.13
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$1.95
Median
$2.09
Typical High
$2.14
Cigna
Setting
Professional
Modifier
None
Typical Low
$16.98
Median
$16.98
Typical High
$16.98
Geisinger
Setting
Professional
Modifier
None
Typical Low
$19.95
Median
$19.95
Typical High
$19.95
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$1.26
Median
$1.26
Typical High
$1.26
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$1.26
Median
$1.26
Typical High
$1.26
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$0.63
Median
$0.63
Typical High
$0.63
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$0.25
Median
$0.25
Typical High
$0.25
Martin's Point
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$0.19
Median
$0.19
Typical High
$0.19
Martin's Point
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$0.13
Median
$0.13
Typical High
$0.13

Where Pennsylvania sits

The same service costs 316.2 times more in Montana than in Arkansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 29th of 51

$2.09

MT $79.43AR $0.25

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.