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Tennessee rates for HCPCS 42330

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$324.01 / $1,821.00 / $6,681.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.35 / $218.01 / $390.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,565.00 / $3,323.00 / $5,774.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.94 / $266.08 / $432.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.94 / $327.50 / $2,277.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.07 / $252.03 / $432.09
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $1,143.96 / $1,173.72
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,209.44 / $1,688.96 / $1,968.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $2,216.00 / $4,099.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.38 / $292.83 / $484.36