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Minnesota 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
$645.65 / $2,884.03 / $6,165.95
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$6,025.60 / $8,511.38 / $13,489.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $8,912.51 / $17,378.01
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$9,120.11 / $16,218.10 / $40,738.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $2,454.71 / $5,754.40
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $2,344.23 / $4,570.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $1,479.11 / $9,332.54
Medica
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$331.13 / $3,019.95 / $4,570.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $6,456.54 / $10,715.19