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Idaho rates for HCPCS 42104

Excision, lesion of palate, uvula; without closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,628.00 / $4,500.00 / $7,205.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.22 / $225.69 / $632.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.55 / $241.63 / $376.31
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.03 / $319.91 / $632.05
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.82 / $265.24 / $420.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $298.77 / $375.88
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,662.74 / $7,239.58 / $9,755.03
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.34 / $295.14 / $437.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,450.00 / $6,124.00 / $7,609.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$219.30 / $290.25 / $470.84