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Tennessee rates for HCPCS 42215

Palatoplasty Cleft Palate Major Revj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,401.84 / $4,069.00 / $10,746.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$637.20 / $809.80 / $1,268.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,686.00 / $5,486.00 / $9,272.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$667.34 / $948.31 / $1,514.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$792.33 / $3,671.00 / $4,939.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$642.48 / $896.06 / $1,457.09
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,571.42 / $16,547.20 / $26,542.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,064.05 / $11,064.05 / $11,064.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,485.00 / $4,937.00 / $10,111.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$642.75 / $906.94 / $1,546.25