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Ohio 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
$1,288.25 / $6,025.60 / $12,302.69
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$537.03 / $10,000.00 / $15,488.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $5,888.44 / $15,135.61
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $812.83 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,379.62 / $21,379.62 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $1,548.82 / $2,754.23
SummaCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $8,128.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $6,606.93 / $10,964.78