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Missouri rates for HCPCS 40650

Repair lip, full thickness; vermilion only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$502.42 / $3,392.00 / $7,996.00
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$218.15 / $283.08 / $387.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $1,963.00 / $4,958.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.38 / $572.09 / $3,064.00
Medica
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$1,031.06 / $1,031.06 / $1,031.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.00 / $815.00 / $1,300.00