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Arizona rates for HCPCS 42104

Excision, lesion of palate, uvula; without closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$417.16 / $2,897.00 / $6,483.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.92 / $201.23 / $395.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$552.79 / $2,064.02 / $3,616.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.68 / $190.15 / $275.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$126.24 / $166.93 / $446.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.90 / $209.19 / $391.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.88 / $211.30 / $472.79
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.52 / $258.54 / $1,619.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$966.00 / $2,517.00 / $4,486.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.10 / $225.28 / $419.48