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Wyoming rates for HCPCS 40701

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,214.55 / $1,214.55 / $1,214.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,099.00 / $4,794.00 / $5,753.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,056.29 / $1,324.38 / $1,986.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,188.00 / $5,188.00 / $18,767.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,242.51 / $2,077.19 / $3,297.80