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Ohio rates for HCPCS 42104

Excision, lesion of palate, uvula; without closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.97 / $2,451.00 / $9,504.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.19 / $208.97 / $358.32
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$918.00 / $2,114.00 / $8,800.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.85 / $171.25 / $284.19
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$126.55 / $151.86 / $187.96
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.19 / $217.00 / $256.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$206.03 / $491.00 / $885.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.43 / $225.85 / $386.32
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$206.03 / $491.00 / $885.00
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.57 / $236.73 / $386.32
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.17 / $224.42 / $319.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.00 / $2,551.00 / $5,457.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.87 / $241.99 / $428.08