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Indiana rates for HCPCS 40702

Plstc Rpr Cl Lip/Nsl Dfrm Prim Bi 1 2 Stgs

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$974.03 / $1,386.00 / $11,093.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$817.30 / $974.03 / $1,129.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,429.00 / $10,338.00 / $26,304.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$848.07 / $1,098.40 / $1,479.76
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$806.12 / $1,174.19 / $1,264.51
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$903.22 / $1,083.85 / $1,282.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,909.74 / $3,909.74 / $3,909.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.47 / $1,107.45 / $1,652.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,699.00 / $10,000.00 / $15,750.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.74 / $987.38 / $1,768.62