go back

Washington rates for HCPCS 15842

Graft for facial nerve paralysis; free muscle flap by microsurgical technique

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,444.75 / $6,928.17 / $20,680.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,057.82 / $3,444.75 / $6,545.02
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $5,167.93 / $18,769.91
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,681.22 / $6,336.26 / $23,362.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$796.68 / $1,285.00 / $2,323.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,074.23 / $4,648.70 / $8,118.42
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,647.45 / $4,143.05 / $6,838.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,647.45 / $4,143.05 / $6,879.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.40 / $1,348.49 / $5,271.44
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,397.80 / $4,698.71 / $5,400.87
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$759.83 / $3,609.50 / $3,683.88
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,727.59 / $6,120.68 / $7,312.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,770.96 / $5,167.93 / $9,885.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,638.19 / $4,953.47 / $6,981.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$629.00 / $1,681.00 / $6,857.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,299.10 / $4,159.13 / $8,160.66
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,883.19 / $2,883.19 / $2,883.19