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Oklahoma rates for HCPCS 42500

Plastic repair of salivary duct, sialodochoplasty; primary or simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $3,684.00 / $12,600.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,175.22 / $6,585.53 / $10,443.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$368.43 / $501.55 / $2,900.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$884.00 / $2,900.00 / $5,543.93