go back

Ear Mold/Insert, Not Disposable

Pennsylvania rates for HCPCS V5264

Ear mold/insert, not disposable, any type

Rates data updated October 2026.

How much does Ear Mold/Insert, Not Disposable cost?

$57.54

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $57.54 for this service. The price depends on where it is billed: about $57.54 from a physician practice, and about $380 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$57.54$57.54 to $63.10
FacilityA hospital or hospital-owned outpatient department$380$105 to $562

How much rates vary

Facilitymedian $380 · 10th to 90th $58 to $5,012Professionalmedian $58 · 10th to 90th $14 to $65
$100$1K$10K$100Kfacility $380professional $58

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$57.54
Median
$57.54
Typical High
$104.71
Aetna
Setting
Professional
Modifier
None
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$64.57
Typical High
$64.57
Cigna
Setting
Professional
Modifier
None
Typical Low
$14.13
Median
$14.13
Typical High
$14.13
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$26.30
Median
$44.67
Typical High
$354.81
Highmark BCBS
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$57.54
Median
$57.54
Typical High
$104.71
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$57.54
Median
$57.54
Typical High
$57.54
UPMC Health Plan
Setting
Facility
Modifier
None
Typical Low
$275.42
Median
$380.19
Typical High
$616.60
United
Setting
Professional
Modifier
None
Typical Low
$34.67
Median
$39.81
Typical High
$60.26

Where Pennsylvania sits

The same service costs 575.4 times more in New York than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 24th of 51

$57.54

NY $8,128VT $14.13

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.