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Missouri rates for HCPCS 42815

Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,760.00 / $5,144.00 / $9,823.00
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
$3,559.00 / $3,559.00 / $3,559.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$502.68 / $830.87 / $5,246.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,285.00 / $4,000.00 / $9,817.00