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Alaska rates for HCPCS 12004

Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$217.60 / $780.16 / $10,900.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.50 / $136.55 / $624.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.43 / $222.49 / $410.71
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$367.15 / $525.02 / $873.78
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.10 / $212.52 / $387.18
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.70 / $317.55 / $557.79
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$367.15 / $525.02 / $873.78
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.88 / $313.50 / $553.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.46 / $328.56 / $330.08