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Alaska rates for HCPCS 40761

Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (Abbe-Estlander type), including sectioning and inserting of pedicle

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $10,964.78 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,621.81 / $5,623.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,630.78 / $3,630.78 / $3,630.78
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $933.25 / $8,128.31
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,570.40 / $3,630.78
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $4,365.16 / $6,025.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $1,621.81 / $8,128.31
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $1,479.11 / $3,630.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $2,884.03 / $4,365.16