| Aetna | Thyrogen (Thyrotropin Alfa) | 2025-12-29 |
| Aetna | Breast Ductal Lavage and Fiberoptic Ductoscopy | 2025-12-29 |
| Aetna | Electrical Stimulation for Chronic Ulcers | 2025-12-29 |
| Aetna | Intra-oral Appliances for Headaches and Trigeminal Neuralgia | 2025-12-29 |
| Aetna | Ocular Photoscreening | 2025-12-29 |
| Aetna | Evaluation of Sinusitis | 2025-12-29 |
| Aetna | Quantitative Pupillometry/Pupillography | 2025-12-29 |
| Aetna | Percutaneous Mitral Valve and Tricuspid Valve Repair | 2025-12-29 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Maternity Ultrasound | 2025-12-29 |
| BCBS Highmark Penn CPA/SEPA/WPA/NEPA | Parenteral Nutrition | 2025-12-29 |