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Ohio 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
$1,575.00 / $8,037.00 / $12,096.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,067.39 / $1,171.22 / $3,191.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,084.00 / $4,437.00 / $19,117.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$972.79 / $1,327.57 / $2,282.59
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,146.18 / $1,669.00 / $1,669.00
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,236.08 / $1,236.08 / $1,328.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,050.67 / $1,460.83 / $2,333.82
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,101.24 / $1,520.01 / $2,333.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.71 / $983.89 / $1,588.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,879.00 / $5,661.00 / $9,483.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$986.01 / $1,249.42 / $2,456.67