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Indiana 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
$1,174.90 / $4,897.79 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,122.02 / $1,949.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $18,197.01 / $26,302.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,288.25 / $2,041.74
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,071.52 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,621.81 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $1,230.27 / $1,778.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $9,549.93 / $16,218.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,096.48 / $2,089.30