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Idaho 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
$131.69 / $238.48 / $586.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.56 / $115.76 / $199.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.24 / $141.40 / $219.75
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.13 / $149.30 / $238.14
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.89 / $212.95 / $258.12
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $205.50
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$255.09 / $491.54 / $606.59
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.53 / $148.16 / $245.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,800.00 / $8,244.00 / $9,193.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.44 / $170.14 / $227.39