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Washington rates for HCPCS 41150

Glssc Composit W/Rescj Floor & Mandibular Rescj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,089.44 / $5,336.73 / $20,680.40
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $2,996.55 / $20,467.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $870.49 / $947.00
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,114.19 / $4,322.89 / $5,576.20
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,182.55 / $4,208.93 / $4,393.18
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,953.56 / $2,953.56 / $2,996.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$650.00 / $1,120.00 / $5,793.00