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Oregon rates for HCPCS 42104

Exc Lesion Palate Uvula W/O Closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.52 / $4,962.67 / $15,341.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.22 / $211.33 / $489.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$255.62 / $255.62 / $2,310.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.37 / $347.30 / $588.12
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.41 / $359.35 / $534.42
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.73 / $339.39 / $536.80
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.00 / $342.72 / $518.87
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$231.42 / $399.26 / $439.52
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.73 / $344.22 / $562.91
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.39 / $379.96 / $570.72
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,382.73 / $9,721.75 / $12,052.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.64 / $403.46 / $591.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,472.00 / $5,130.00 / $9,858.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.81 / $444.24 / $679.62