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Pennsylvania rates for HCPCS V2715

Prism, Per Lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.76 / $11.24 / $12.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.76 / $14.76 / $14.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.22 / $20.22 / $20.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.70 / $6.70 / $6.70
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.46 / $25.18 / $40.36
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.13 / $11.29 / $13.17
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.22 / $20.22 / $20.22
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.70 / $6.70 / $6.70
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.56 / $10.56 / $14.04
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.56 / $14.04 / $17.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.80 / $7.36 / $12.27