go back

Nebraska 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
$4,241.22 / $10,563.53 / $20,928.72
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$5,473.67 / $10,574.79 / $12,032.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,187.86 / $8,386.12 / $15,742.91
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$670.77 / $1,309.57 / $8,632.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,233.18 / $1,570.69 / $2,865.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,341.00 / $7,441.00 / $8,816.00