go back

Texas rates for HCPCS 42104

Excision, lesion of palate, uvula; without closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.69 / $2,444.00 / $7,408.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.88 / $203.58 / $305.69
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.25 / $128.25 / $128.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.79 / $236.43 / $947.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.50 / $200.54 / $337.45
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.39 / $3,098.76 / $3,098.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.85 / $213.12 / $2,213.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.94 / $236.05 / $404.49
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $55.00 / $956.88
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$987.44 / $1,560.08 / $1,823.40
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.58 / $214.07 / $371.68
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.41 / $246.67 / $378.45
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $216.90 / $582.10
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.93 / $214.91 / $383.88
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.07 / $257.62 / $463.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$597.00 / $2,054.00 / $4,563.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.18 / $234.00 / $360.92
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.44 / $209.86 / $284.88