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Pennsylvania rates for HCPCS B4083

Stomach tube - Levine type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $3.02
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.14 / $2.14 / $2.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.17 / $1.17 / $1.66
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.62 / $2.24 / $2.29
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.62 / $2.24 / $2.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $2.24 / $3.47