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California rates for HCPCS 49904

Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,514.34 / $9,674.00 / $22,788.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,097.00 / $6,264.00 / $14,341.00
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.90 / $100.00 / $7,344.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$633.00 / $766.00 / $5,431.00
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$644.82 / $975.80 / $1,971.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,276.78 / $1,665.52 / $3,160.43
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $21,890.68 / $22,535.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,330.46 / $1,702.37 / $2,432.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,055.00 / $4,820.00 / $20,279.00