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Ohio rates for HCPCS 42104

Excision, lesion of palate, uvula; without closure

Facilitymedian $2,884 · 10th–90th $229$9,7720%10%10th90th$2,884Professionalmedian $200 · 10th–90th $129$3720%10%20%10th90th$200$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $2,951.21 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $426.58
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $218.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $2,691.53 / $7,943.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $169.82 / $275.42
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $144.54 / $186.21
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $229.09 / $616.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $229.09 / $416.87
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $302.00 / $616.60
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $229.09 / $398.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $104.71
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $4,073.80
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $213.80 / $346.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $2,570.40 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $194.98 / $331.13