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North Carolina rates for HCPCS 42500

Plastic repair of salivary duct, sialodochoplasty; primary or simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.25 / $655.76 / $7,724.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$515.00 / $2,844.33 / $5,654.79
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.25 / $484.76 / $755.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$773.00 / $1,208.00 / $9,324.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,394.60 / $2,394.60 / $26,542.00