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Minnesota 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
$1,258.93 / $1,258.93 / $1,258.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $8,709.64 / $22,387.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $4,897.79 / $11,481.54
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $4,677.35 / $9,120.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,995.26 / $3,890.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $3,311.31 / $8,511.38