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Alaska rates for HCPCS 21175

Rcnstj Bifrontal Superior-Lat Orb Rims & Lwr Fhd

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,386.01 / $9,813.00 / $14,552.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,001.22 / $6,386.01 / $10,830.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,477.80 / $7,408.03 / $9,432.06
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,070.77 / $10,830.89 / $15,163.25
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,371.95 / $6,446.34 / $13,086.71
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,977.50 / $10,946.30 / $13,362.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,070.77 / $10,830.89 / $15,163.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,290.94 / $10,853.50 / $14,020.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,831.32 / $11,831.32 / $11,831.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,884.42 / $10,371.24 / $13,038.12