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Oklahoma rates for HCPCS 15758

Free fascial flap with microvascular anastomosis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $3,779.00 / $12,600.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,515.00 / $2,830.93 / $5,690.67
Medica
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$6,409.11 / $6,409.11 / $6,409.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$880.00 / $2,900.00 / $5,543.93