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Arizona rates for HCPCS 40804

Rmvl Embedded Fb Vestibule Mouth Smpl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$896.00 / $3,055.00 / $6,329.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.20 / $181.48 / $630.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.29 / $136.61 / $223.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.88 / $173.25 / $259.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.90 / $191.04 / $339.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.69 / $199.63 / $1,900.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.97 / $253.35 / $1,409.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,424.00 / $2,522.00 / $5,029.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.53 / $218.76 / $406.36