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Washington rates for HCPCS 13133

Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 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
$224.69 / $466.27 / $13,750.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.51 / $158.96 / $388.16
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.96 / $242.96 / $242.96
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.59 / $564.64 / $12,000.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.20 / $337.44 / $1,249.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$421.10 / $731.00 / $731.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.59 / $255.27 / $443.14
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.19 / $270.66 / $407.57
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.35 / $279.04 / $424.48
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.17 / $250.50 / $441.36
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.03 / $311.12 / $338.64
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.59 / $225.59 / $230.33
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.28 / $292.73 / $422.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$580.97 / $580.97 / $731.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.63 / $244.97 / $401.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.00 / $588.00 / $5,793.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.71 / $263.12 / $500.25
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.33 / $131.33 / $182.64