go back

Missouri 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
$1,495.58 / $4,261.00 / $12,154.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,232.00 / $4,319.00 / $10,043.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,530.00 / $2,530.00 / $2,530.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,236.26 / $1,954.44 / $3,767.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,189.00 / $3,300.00 / $11,186.00