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Illinois rates for HCPCS 11976

Removal Implantable Contraceptive Capsules

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.36 / $1,055.00 / $5,091.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.44 / $129.68 / $235.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$808.43 / $1,049.92 / $1,880.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.72 / $162.80 / $245.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.00 / $463.00 / $480.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.88 / $152.29 / $251.77
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.00 / $205.80 / $401.58
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.65 / $118.16 / $197.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $227.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$711.00 / $1,905.00 / $4,342.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.90 / $185.40 / $313.86