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Pennsylvania rates for HCPCS G0249

Provision of test materials and equipment for home INR monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include four tests

Professionalmedian $65 · 10th–90th $39–$1580%10%10th90th$65$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $67.61 / $302.00
Aetna
Facility/Professional
Professional
Modifier
52
Typical Low / Median / Typical High
$22.91 / $22.91 / $22.91
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $83.18
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $69.18
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $61.66 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $91.20 / $131.83
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $63.10 / $66.07
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $53.70 / $125.89
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $63.10 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $42.66 / $128.82