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Nebraska rates for HCPCS 13122

Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,191.09 / $4,241.22 / $13,841.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.23 / $117.63 / $695.96
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.87 / $230.87 / $230.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,442.56 / $3,212.63 / $6,214.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.06 / $148.53 / $234.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.57 / $243.77 / $378.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.85 / $195.14 / $620.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.09 / $273.26 / $937.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.31 / $250.42 / $394.19
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.15 / $234.02 / $343.48
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.67 / $140.31 / $250.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,031.00 / $1,775.00 / $4,406.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.09 / $282.77 / $298.99