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Minnesota rates for HCPCS 20902

Bone Graft Any Donor Area Major/Large

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$268.54 / $268.54 / $9,469.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,336.60 / $11,716.49 / $25,424.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$648.21 / $919.72 / $2,212.50
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$30.65 / $30.65 / $30.65
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$589.28 / $840.84 / $1,742.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.44 / $574.84 / $5,499.00
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$78.72 / $78.72 / $78.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,121.00 / $5,499.00 / $9,810.00