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Iowa rates for HCPCS 15769

Grafting Of Autologous Soft Tiss By Direct Exc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,366.93 / $4,889.39 / $7,120.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$437.41 / $719.44 / $1,228.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.98 / $1,082.17 / $1,352.71
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.53 / $702.35 / $2,721.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$593.10 / $1,262.85 / $9,495.24
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.66 / $879.41 / $1,793.99
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,061.86 / $2,936.00 / $3,914.66
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$777.18 / $1,105.33 / $1,475.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,341.00 / $7,091.00 / $10,320.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.85 / $729.97 / $1,558.87
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$683.35 / $865.00 / $1,017.70