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California rates for HCPCS 40804

Rmvl Embedded Fb Vestibule Mouth Smpl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.03 / $7,281.00 / $20,135.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.13 / $196.07 / $1,064.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,723.00 / $4,505.00 / $9,119.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.94 / $236.17 / $546.89
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.90 / $100.00 / $1,684.75
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.22 / $195.44 / $420.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.54 / $222.67 / $527.37
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.06 / $145.51 / $277.70
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.23 / $215.11 / $384.09
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $808.62 / $819.06
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$854.16 / $1,409.04 / $1,662.98
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.20 / $191.06 / $324.88
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.88 / $233.66 / $510.49
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.00 / $391.00 / $660.29
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.06 / $107.80 / $280.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,048.00 / $4,060.00 / $9,131.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.63 / $222.96 / $607.29