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Missouri rates for HCPCS 00813

Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
QX
Low / Median / High Price
$1,258.93 / $1,258.93 / $1,258.93
Aetna
Facility/Professional
Facility
Modifier
QZ
Low / Median / High Price
$162.18 / $162.18 / $162.18
Aetna
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$478.63 / $707.95 / $1,348.96
Aetna
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$245.47 / $389.05 / $562.34
Aetna
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$239.88 / $398.11 / $588.84
Aetna
Facility/Professional
Professional
Modifier
QY
Low / Median / High Price
$309.03 / $407.38 / $707.95
Aetna
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$380.19 / $630.96 / $812.83
Ambetter
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$147.91 / $199.53 / $446.68
Ambetter
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$81.28 / $109.65 / $295.12
Ambetter
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$77.62 / $107.15 / $295.12
Ambetter
Facility/Professional
Professional
Modifier
QY
Low / Median / High Price
$67.61 / $95.50 / $354.81
Ambetter
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$141.25 / $177.83 / $457.09
Medica
Facility/Professional
Facility
Modifier
QK
Low / Median / High Price
$39.81 / $39.81 / $39.81
Medica
Facility/Professional
Facility
Modifier
QX
Low / Median / High Price
$39.81 / $39.81 / $39.81
Medica
Facility/Professional
Facility
Modifier
QY
Low / Median / High Price
$39.81 / $39.81 / $39.81
Qualchoice
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$407.38 / $407.38 / $407.38
Qualchoice
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$204.17 / $204.17 / $204.17
Qualchoice
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$467.74 / $524.81 / $588.84