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Minnesota 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
$1,110.15 / $1,110.15 / $8,011.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,110.15 / $1,234.67 / $1,980.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,523.94 / $10,376.60 / $21,650.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,893.89 / $2,612.53 / $4,189.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,851.91 / $4,044.36 / $9,729.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,970.05 / $3,385.92 / $5,080.07
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,318.39 / $3,697.51 / $7,660.83
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,938.22 / $2,920.68 / $4,644.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,273.06 / $1,937.27 / $9,793.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,374.36 / $2,243.88 / $8,151.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,940.00 / $8,689.00 / $11,531.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,390.78 / $2,125.78 / $4,685.60