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Minnesota rates for HCPCS 15769

Grafting Of Autologous Soft Tiss By Direct Exc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$458.38 / $1,950.00 / $6,714.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$431.22 / $491.67 / $1,159.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,750.60 / $5,762.11 / $12,749.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$766.91 / $1,059.34 / $1,698.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,158.96 / $1,643.54 / $3,953.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$799.65 / $1,374.36 / $2,062.01
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$942.15 / $1,502.59 / $3,113.20
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$786.73 / $1,185.51 / $1,885.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$516.64 / $814.61 / $8,827.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$550.22 / $900.45 / $1,914.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,293.00 / $6,652.00 / $9,810.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.23 / $986.07 / $1,825.73