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Nebraska rates for HCPCS 42200

Palatoplasty for cleft palate, soft and/or hard palate only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $7,943.28 / $15,135.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $954.99 / $1,949.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,748.98 / $15,488.17 / $30,199.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,412.54 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $1,698.24 / $2,884.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $1,412.54 / $8,709.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,819.70 / $9,772.37
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,187.76 / $2,884.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $2,041.74 / $2,884.03
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $1,348.96 / $2,398.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,309.57 / $7,413.10 / $9,120.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,445.44 / $2,344.23