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Idaho rates for HCPCS 40701

Plstc Rpr Cl Lip/Nsl Dfrm Prim Bi 1 Stg Px

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,805.00 / $6,899.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,169.83 / $1,799.77 / $3,434.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$942.27 / $1,642.28 / $2,091.17
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,064.09 / $1,799.77 / $3,606.25
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,922.98 / $2,047.50 / $2,330.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $1,862.18
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,660.78 / $14,097.25 / $17,807.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,211.81 / $2,380.07 / $2,408.77
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,120.00 / $22,317.00 / $27,159.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,219.04 / $1,523.28 / $2,159.98