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Pennsylvania rates for HCPCS G0121

Colorectal Cancer Screening; Colonoscopy On Individual Not Meeting Criteria For High Risk (Special Coverage Instructions Apply)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$700.00 / $2,568.00 / $6,068.07
Aetna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$155.54 / $1,495.47 / $2,583.96
Aetna
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$79.44 / $155.66 / $590.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.21 / $303.64 / $616.19
Aetna
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$37.88 / $87.81 / $194.91
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.46 / $269.27 / $332.76
Ambetter
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$90.53 / $140.44 / $153.47
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.70 / $302.70 / $692.88
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.69 / $3,159.00 / $14,886.03
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.76 / $361.60 / $617.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$429.00 / $760.00 / $1,463.23
Cigna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$194.94 / $194.94 / $194.94
Cigna
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$48.74 / $48.74 / $48.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.75 / $301.75 / $301.75
Cigna
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$41.90 / $163.72 / $163.72
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$404.04 / $404.04 / $404.04
Emblem Health
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$202.40 / $202.40 / $202.40
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.70 / $511.33 / $680.43
Emblem Health
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$198.85 / $243.02 / $336.90
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$825.04 / $1,819.76 / $3,310.69
Highmark BCBS
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$454.46 / $1,329.60 / $1,708.98
Highmark BCBS
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$2,678.92 / $4,007.95 / $4,764.57
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.34 / $259.18 / $330.46
Highmark BCBS
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$212.34 / $251.09 / $356.39
Independence Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.70 / $504.50 / $10,182.00
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$561.86 / $2,202.00 / $5,463.05
Martin's Point
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$198.60 / $772.90 / $2,553.96
Martin's Point
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$87.07 / $163.44 / $868.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.09 / $342.57 / $856.00
Martin's Point
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$52.13 / $128.86 / $288.33
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.15 / $805.66 / $1,625.30
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.03 / $475.10 / $858.10
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.68 / $760.00 / $1,865.00
Priority Health
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$194.94 / $194.94 / $194.94
Priority Health
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$48.74 / $48.74 / $48.74
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.75 / $301.75 / $301.75
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.69 / $329.50 / $437.28
UPMC Health Plan
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$89.50 / $164.74 / $437.91
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.69 / $323.22 / $414.85
UPMC Health Plan
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$89.50 / $161.58 / $284.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.00 / $1,090.00 / $3,742.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.27 / $414.72 / $661.92
United
Facility/Professional
Professional
Modifier
53
Low / Median / High Price
$204.84 / $204.84 / $204.84