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North Carolina rates for HCPCS 15758

Free fascial flap with microvascular anastomosis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,338.00 / $3,494.30 / $8,413.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,224.76 / $2,803.20 / $3,923.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,526.00 / $7,659.00 / $10,502.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $10,398.29 / $12,811.25
Wellcare
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$3,188.38 / $3,582.16 / $6,951.51