go back

Idaho rates for HCPCS 19380

Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,451.58 / $3,981.14 / $12,053.89
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$6,094.88 / $6,094.88 / $33,044.50
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$796.80 / $1,280.81 / $1,498.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,735.84 / $15,339.80 / $19,820.41
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$14,624.12 / $23,009.70 / $30,811.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,120.00 / $22,317.00 / $27,159.00