go back

Maryland rates for HCPCS 40700

Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,760.83 / $6,760.83 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,174.90 / $3,715.35
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,071.52 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,071.52 / $1,819.70
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,071.52 / $2,041.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $2,884.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,047.13 / $1,995.26
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,000.00 / $1,479.11