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Alaska rates for HCPCS 40701

Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,421.91 / $13,413.92 / $20,143.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,255.91 / $6,255.91 / $6,296.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,060.85 / $2,060.85 / $3,960.63
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,255.91 / $8,758.27 / $8,945.95
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,622.24 / $3,496.32 / $6,305.25
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,768.00 / $4,820.85 / $9,728.10
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,255.91 / $8,758.27 / $8,945.95
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,636.85 / $3,613.72 / $8,076.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,315.55 / $3,168.50 / $4,780.01