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Illinois 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
$663.00 / $2,145.28 / $6,614.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$852.91 / $2,924.46 / $9,720.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,528.05 / $6,744.80 / $13,517.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.00 / $11,310.00 / $14,224.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$720.69 / $1,111.81 / $3,588.71
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,152.00 / $5,000.00 / $8,995.00