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Washington rates for HCPCS 42505

Plastic repair of salivary duct, sialodochoplasty; secondary or complicated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$817.24 / $1,474.70 / $17,967.00
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,255.42 / $15,555.67 / $26,542.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$883.20 / $1,075.31 / $6,910.09
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$532.58 / $1,015.09 / $5,194.27
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$773.75 / $1,069.99 / $1,167.81
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$777.35 / $1,994.21 / $3,953.90
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,761.59 / $16,595.73 / $31,745.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,400.00 / $3,509.00 / $16,315.00