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Virginia rates for HCPCS 42960

Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple

Facilitymedian $363 · 10th–90th $178–$5,2480%10%10th90th$363Professionalmedian $200 · 10th–90th $145–$3470%10%10th90th$200$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $2,570.40 / $7,079.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,570.40 / $2,951.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $309.03 / $363.08
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $169.82 / $346.74
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $257.04 / $346.74
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $218.78 / $338.84
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $208.93 / $707.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $831.76 / $2,344.23