go back

Pennsylvania rates for HCPCS G0415

Open Treatment Of Posterior Pelvic Bone Fracture And/Or Dislocation For

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,462.00 / $4,680.00 / $9,676.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,551.82 / $1,551.82 / $1,551.82
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,301.00 / $5,079.00 / $10,527.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,551.82 / $1,551.82 / $1,551.82
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,190.97 / $1,340.17 / $1,340.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,468.00 / $4,563.00 / $9,631.00