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Arizona rates for HCPCS 13122

Repair Complex Scalp/Arm/Leg Ea Addl 5 Cm/<

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$453.23 / $2,260.00 / $5,506.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.81 / $105.57 / $192.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.80 / $1,267.20 / $2,072.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.86 / $77.72 / $119.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.95 / $111.76 / $187.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.58 / $119.36 / $1,448.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.96 / $128.22 / $937.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$716.00 / $1,535.00 / $2,175.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.24 / $123.76 / $164.57