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Indiana rates for HCPCS 14021

Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $1,380.38 / $8,128.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $812.83 / $1,778.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $8,317.64 / $10,471.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $891.25 / $1,318.26
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $707.95 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $912.01 / $1,380.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $3,715.35 / $6,456.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $812.83 / $1,318.26