go back

Arizona 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
$281.84 / $1,698.24 / $5,128.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $147.91 / $407.38
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $81.28 / $87.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $204.17 / $331.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $89.13 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $131.83 / $204.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $144.54 / $1,862.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $165.96 / $1,071.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $1,202.26 / $2,187.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $120.23 / $190.55