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Idaho rates for HCPCS 42500

Plastic repair of salivary duct, sialodochoplasty; primary or simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,897.00 / $4,500.00 / $7,761.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$427.58 / $705.40 / $1,314.95
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,662.17 / $13,168.12 / $17,807.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,550.00 / $12,152.00 / $12,233.00