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Tennessee 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
$1,076.00 / $3,329.00 / $6,681.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,395.00 / $5,269.00 / $9,272.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$608.17 / $3,203.00 / $4,038.10
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,993.70 / $16,547.20 / $26,542.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,485.00 / $4,937.00 / $10,111.00