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Washington rates for HCPCS 12053

Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$396.43 / $915.49 / $12,214.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.27 / $314.99 / $622.82
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.69 / $146.69 / $146.69
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.92 / $1,130.00 / $2,206.01
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.33 / $692.78 / $2,702.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$334.00 / $334.00 / $507.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.70 / $472.17 / $970.26
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$282.14 / $464.76 / $839.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.50 / $495.23 / $880.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.96 / $285.80 / $784.55
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$349.52 / $602.00 / $732.31
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.57 / $493.77 / $499.50
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.68 / $526.72 / $915.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$732.75 / $1,129.34 / $2,161.55
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.20 / $503.58 / $845.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.00 / $414.00 / $5,793.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.99 / $528.32 / $1,041.19
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.33 / $233.33 / $404.60