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Minnesota rates for HCPCS 42104

Exc Lesion Palate Uvula W/O Closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$129.25 / $213.66 / $2,384.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.92 / $201.05 / $367.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$648.74 / $5,064.68 / $11,441.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.76 / $464.26 / $769.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$498.98 / $778.77 / $1,873.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$268.82 / $527.71 / $929.42
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.41 / $686.62 / $1,475.15
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.00 / $469.97 / $833.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.91 / $288.72 / $626.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.14 / $555.30 / $1,619.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,224.00 / $3,500.00 / $8,474.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.95 / $438.79 / $871.85