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Arizona rates for HCPCS 40800

Drg Absc Cst Hmtma Vestibule Mouth Smpl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$896.00 / $2,304.00 / $6,305.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.13 / $187.69 / $408.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.33 / $298.66 / $488.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.41 / $179.25 / $268.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$283.64 / $283.64 / $283.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.69 / $199.51 / $354.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.60 / $206.46 / $1,371.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.62 / $268.20 / $1,503.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,068.00 / $1,711.00 / $3,268.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.20 / $223.20 / $394.43