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Pennsylvania rates for HCPCS L8631

Metacarpophalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)

Facilitymedian $1,148 · 10th–90th $1,148–$2,6300%50%90th$1,148Professionalmedian $1,288 · 10th–90th $1,122–$2,2390%20%40%10th90th$1,288$1.0$10.0$100.0$1.0K$10.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,288.25 / $2,238.72
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,089.30 / $2,630.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,479.11
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,467.37 / $5,011.87
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $2,630.27
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,819.70 / $2,630.27
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,148.15
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,318.26 / $2,238.72
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,715.35 / $5,128.61
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,454.71
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,548.82 / $1,819.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,445.44 / $2,630.27