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Tennessee rates for HCPCS 30920

Ligation arteries; internal maxillary artery, transantral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $2,454.71 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,000.00 / $1,819.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $4,073.80 / $5,888.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,230.27 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $2,089.30 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,096.48 / $1,659.59
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,912.51 / $8,912.51 / $45,708.82
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,760.83 / $7,244.36 / $7,244.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.23 / $4,570.88 / $7,585.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,096.48 / $1,819.70