go back

Texas 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
$893.00 / $3,500.00 / $10,481.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,038.63 / $2,974.50 / $7,674.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,673.28 / $4,816.97 / $10,229.40
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$324.38 / $1,291.25 / $2,551.83
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$600.45 / $6,358.79 / $6,358.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,207.78 / $2,207.78 / $2,207.78
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,723.79 / $26,542.00 / $26,542.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$629.15 / $833.05 / $1,504.55
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$629.15 / $853.61 / $1,542.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,634.00 / $4,345.00 / $10,600.00