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Missouri 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
$955.60 / $4,261.00 / $9,823.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,912.00 / $4,994.00 / $8,347.50
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,224.00 / $4,643.00 / $17,951.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,488.00 / $13,882.00 / $15,775.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$694.08 / $1,411.19 / $20,551.18
Medica
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$7,633.50 / $7,633.50 / $7,633.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,156.00 / $4,000.00 / $10,781.00