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Pennsylvania rates for HCPCS L8049

Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a nonphysician

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $109.65 / $109.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $28.18 / $50.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.59 / $12.59 / $12.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.72 / $10.72 / $10.72
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $21.88 / $21.88
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.18 / $109.65
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $28.18 / $50.12
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.47 / $16.98 / $20.42
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.47 / $16.98 / $20.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.72 / $17.78 / $21.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $14.45 / $21.88