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Arizona rates for HCPCS 19370

Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,671.00 / $3,857.00 / $7,562.14
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,472.75 / $5,205.00 / $7,177.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$830.45 / $3,126.40 / $5,113.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,833.49 / $2,833.49 / $2,833.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.71 / $840.27 / $6,117.00
Medica
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,980.28 / $3,980.28 / $3,980.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,912.00 / $4,545.00 / $7,217.00