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Pennsylvania rates for HCPCS G0104

Colorectal cancer screening; flexible sigmoidoscopy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $1,949.84 / $6,165.95
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,511.38 / $77,624.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $398.11 / $575.44
Cigna
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$24.55 / $24.55 / $24.55
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $120.23 / $120.23
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $1,995.26 / $3,311.31
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $1,737.80 / $6,165.95
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $131.83 / $407.38
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.70 / $58.88 / $257.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $1,258.93 / $3,715.35