go back

Washington rates for HCPCS 42104

Excision, lesion of palate, uvula; without closure

Facilitymedian $407 · 10th–90th $191$10,4710%10%10th90th$407Professionalmedian $234 · 10th–90th $132$5500%10%20%10th90th$234$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
$257.04 / $2,951.21 / $16,982.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $218.78 / $630.96
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $489.78
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $8,511.38 / $17,378.01
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $323.59 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $630.96 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $288.40 / $575.44
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $309.03 / $676.08
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $288.40 / $512.86
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $89.13
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $416.87 / $436.52
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $295.12 / $302.00
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $309.03 / $549.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,888.44 / $8,912.51 / $17,378.01
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $331.13 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $9,549.93 / $18,620.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $257.04 / $457.09
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $223.87 / $316.23