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Texas rates for HCPCS 42505

Plastic repair of salivary duct, sialodochoplasty; secondary or complicated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$657.00 / $3,500.00 / $10,893.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,910.17 / $7,033.27 / $14,454.58
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.34 / $400.34 / $556.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,500.00 / $3,795.09 / $4,619.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,165.00 / $11,500.00 / $26,542.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$458.83 / $621.21 / $1,127.91
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$459.82 / $627.34 / $1,250.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,093.00 / $5,870.00 / $13,237.00