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New York 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
$838.41 / $5,164.00 / $11,292.60
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$4,366.02 / $5,502.33 / $11,524.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,283.00 / $6,758.00 / $20,583.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$943.23 / $2,390.00 / $10,957.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$760.71 / $760.71 / $6,511.02
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.00 / $905.00 / $1,783.89
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,028.03 / $6,116.49 / $7,757.57
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$6,798.99 / $9,382.79 / $11,610.00
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$597.00 / $760.71 / $23,610.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,264.00 / $5,735.00 / $11,200.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$720.91 / $720.91 / $1,963.42