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Indiana rates for HCPCS 40801

Drg Absc Cst Hmtma Vestibule Mouth Comp

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.22 / $321.01 / $7,212.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.22 / $271.36 / $321.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,804.00 / $4,353.00 / $8,052.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.62 / $233.00 / $361.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.90 / $240.76 / $361.29
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.51 / $321.01 / $401.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$365.92 / $365.92 / $365.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.71 / $299.94 / $595.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.00 / $2,252.00 / $4,426.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.31 / $354.73 / $650.47