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Indiana rates for HCPCS 00731

Anesthesia Upper Gi Endoscopic Px Nos

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.00 / $480.00 / $540.00
Aetna
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$344.80 / $549.00 / $733.13
Aetna
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$251.58 / $337.24 / $493.64
Aetna
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$274.50 / $303.02 / $425.21
Aetna
Facility/Professional
Professional
Modifier
QY
Low / Median / High Price
$155.25 / $275.33 / $472.50
Aetna
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$261.00 / $403.07 / $563.02
Ambetter
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$135.59 / $255.84 / $560.00
Ambetter
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$69.27 / $98.95 / $262.50
Ambetter
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$79.16 / $129.66 / $193.94
Ambetter
Facility/Professional
Professional
Modifier
QY
Low / Median / High Price
$70.20 / $110.82 / $162.08
Ambetter
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$135.59 / $221.65 / $750.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$235.00 / $235.00 / $453.55
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.22 / $155.93 / $226.63
Cigna
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$180.00 / $180.00 / $180.00
Cigna
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$180.00 / $180.00 / $180.00
Cigna
Facility/Professional
Professional
Modifier
QY
Low / Median / High Price
$180.00 / $180.00 / $180.00
United
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$75.00 / $75.00 / $75.00
United
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$85.00 / $85.00 / $95.00