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Missouri 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
$1,760.00 / $5,646.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,051.81 / $1,245.18 / $4,499.67
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,114.00 / $4,643.00 / $10,043.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,115.42 / $1,398.11 / $2,226.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,056.46 / $1,510.35 / $2,510.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $2,441.96 / $26,542.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,076.97 / $1,803.85 / $8,754.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,516.00 / $4,530.07 / $9,817.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,124.48 / $1,715.53 / $3,254.89