go back

Indiana rates for HCPCS 19303

Mastectomy, simple, complete

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,030.00 / $5,985.83 / $19,148.00
Aetna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$13,539.91 / $13,539.91 / $13,539.91
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$4,499.20 / $7,250.13 / $25,286.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,321.00 / $8,832.00 / $25,131.90
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.95 / $1,155.30 / $1,789.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,594.87 / $3,594.87 / $3,594.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,932.00 / $8,025.00 / $11,038.00