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Arizona rates for HCPCS 42330

Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,162.00 / $2,771.00 / $6,305.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.19 / $215.88 / $397.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$632.79 / $2,362.71 / $4,140.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.41 / $227.16 / $297.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.94 / $162.57 / $266.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.68 / $236.97 / $422.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.15 / $237.26 / $507.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.58 / $284.73 / $1,748.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.00 / $2,399.00 / $4,640.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.90 / $245.69 / $450.80