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Oklahoma rates for HCPCS 40804

Rmvl Embedded Fb Vestibule Mouth Smpl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$197.02 / $3,683.00 / $18,600.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.14 / $197.02 / $197.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.87 / $148.27 / $217.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.81 / $195.62 / $251.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.84 / $202.74 / $294.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.14 / $223.81 / $2,974.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.68 / $301.77 / $1,409.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.00 / $1,760.00 / $3,790.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.19 / $223.50 / $325.70