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Illinois rates for HCPCS 12055

Repair Intermediate F/E/E/N/L&/Muc 12.6-20.0cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$473.38 / $1,486.00 / $5,091.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.93 / $421.80 / $819.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.75 / $2,770.96 / $6,043.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.87 / $525.54 / $838.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$620.00 / $620.00 / $643.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.49 / $497.69 / $838.41
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.79 / $676.98 / $1,480.34
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
$352.35 / $381.42 / $676.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $765.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.00 / $1,032.00 / $3,686.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.75 / $592.58 / $1,023.71