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Tennessee rates for HCPCS 15758

Free Fascial Flap W/Microvascular Anastomosis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,635.00 / $2,800.00 / $7,602.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,428.00 / $2,344.00 / $4,147.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $12,811.25 / $13,130.70
Lucent Health
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$3,582.16 / $6,951.51 / $6,951.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,794.00 / $3,616.00 / $6,003.00