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Pennsylvania rates for HCPCS V5264

Ear Mold/Insert Not Disposable Any Type (Not Covered By Medicare. Statute Reference: 1862a7)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.82 / $57.45 / $68.54
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.41 / $64.77 / $64.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.25 / $14.25 / $14.25
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.49 / $57.45 / $131.90
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.84 / $74.84 / $81.00
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.25 / $14.25 / $14.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.00 / $48.00 / $48.00