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Indiana rates for HCPCS 42104

Excision, lesion of palate, uvula; without closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$132.88 / $325.29 / $7,212.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.04 / $194.00 / $271.50
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$800.00 / $5,083.00 / $8,240.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.26 / $146.69 / $227.81
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.43 / $160.46 / $268.74
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.01 / $223.77 / $292.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$198.98 / $198.98 / $538.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.22 / $215.69 / $373.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.00 / $3,817.00 / $5,402.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.70 / $234.01 / $452.20