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Missouri rates for HCPCS 42505

Plastic repair of salivary duct, sialodochoplasty; secondary or complicated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$668.07 / $4,498.00 / $12,154.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,114.00 / $4,050.00 / $9,663.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,125.00 / $3,125.00 / $3,125.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$454.10 / $720.80 / $2,516.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,285.00 / $4,000.00 / $9,817.00