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Illinois 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
$1,000.00 / $2,836.00 / $9,560.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,827.04 / $10,651.76 / $13,656.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,244.41 / $9,177.43 / $16,262.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$996.00 / $11,310.00 / $14,224.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$866.16 / $1,299.24 / $3,707.28
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,300.00 / $5,978.00 / $12,241.00