go back

Iowa rates for HCPCS 15758

Free fascial flap with microvascular anastomosis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,468.00 / $4,917.20 / $8,042.03
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,075.11 / $3,285.21 / $4,205.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,433.30 / $4,191.66 / $6,608.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,494.10 / $5,256.34 / $6,995.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,217.00 / $5,732.00 / $8,342.00