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Missouri 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
$1,047.13 / $3,548.13 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $912.01 / $3,090.30
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $794.33 / $794.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $891.25 / $1,348.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $891.25 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,000.00 / $1,698.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $1,174.90 / $11,748.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,202.26 / $6,456.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,412.54 / $3,019.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $870.96 / $1,412.54