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Tennessee rates for HCPCS 42220

Palatoplasty for cleft palate; secondary lengthening procedure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,153.78 / $2,794.39 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$494.19 / $635.91 / $1,029.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,439.00 / $5,060.00 / $9,272.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.08 / $724.40 / $1,207.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$652.83 / $3,203.00 / $4,038.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526.45 / $722.29 / $1,172.72
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,764.95 / $16,547.20 / $26,542.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,481.71 / $8,481.71 / $8,481.71
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
$505.51 / $720.52 / $1,255.78