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Virginia rates for HCPCS 42500

Plastic repair of salivary duct, sialodochoplasty; primary or simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$488.65 / $3,633.00 / $8,003.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,153.00 / $7,363.00 / $9,410.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$490.00 / $925.00 / $3,282.37
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$427.27 / $527.79 / $754.01
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$383.51 / $527.23 / $795.88
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$350.11 / $438.61 / $806.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$908.00 / $5,815.00 / $12,680.00