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Delaware rates for HCPCS 41250

Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,949.00 / $3,949.00 / $6,907.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,881.00 / $1,881.00 / $1,881.00
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.57 / $179.57 / $179.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.00 / $143.00 / $143.00