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Alaska rates for HCPCS 21705

Division of scalenus anticus; with resection of cervical rib

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,236.00 / $9,813.00 / $15,586.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.19 / $2,623.17 / $2,623.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,328.79 / $1,811.70 / $2,222.71
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.33 / $2,623.17 / $3,672.44
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,286.58 / $1,543.89 / $3,134.27
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,923.75 / $2,641.80 / $3,170.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.33 / $2,623.17 / $3,672.44
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$802.39 / $2,600.40 / $3,416.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,449.36 / $2,536.38 / $3,188.59