go back

Washington rates for HCPCS 11971

Removal Tissue Expander W/O Insertion Implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$746.11 / $2,769.52 / $14,464.32
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$16,707.90 / $16,707.90 / $16,707.90
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,241.82 / $7,873.79 / $15,403.47
Asuris Northwest Health
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$8,704.54 / $12,078.71 / $23,367.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$421.10 / $731.00 / $2,846.84
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$444.50 / $734.11 / $2,018.24
Kaiser Permanente
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$6,008.05 / $8,172.30 / $19,662.53
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$587.55 / $922.59 / $1,756.22
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$735.67 / $762.73 / $1,241.82
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,221.67 / $8,047.87 / $15,403.47
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$7,832.51 / $12,071.81 / $23,105.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,232.00 / $1,981.00 / $10,522.00