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Illinois rates for HCPCS 12004

Simple Rpr Scalp/Neck/Ax/Genit/Trunk 7.6-12.5cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.86 / $377.13 / $2,258.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.23 / $114.34 / $234.09
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.66 / $72.66 / $72.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$273.41 / $688.40 / $1,501.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.43 / $141.19 / $225.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.98 / $147.31 / $242.91
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.13 / $195.38 / $556.89
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
$83.37 / $94.84 / $182.39
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $206.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.00 / $891.00 / $3,685.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.05 / $185.29 / $290.52