go back

Tennessee rates for HCPCS 42104

Exc Lesion Palate Uvula W/O Closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$284.92 / $2,036.00 / $6,681.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.68 / $195.73 / $367.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,565.00 / $3,323.00 / $5,774.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$142.85 / $237.19 / $397.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.82 / $455.00 / $1,992.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.46 / $225.77 / $398.34
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $934.92 / $956.88
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$987.44 / $1,560.08 / $1,823.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.00 / $2,257.00 / $4,099.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.29 / $254.89 / $449.59