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Nebraska 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
$4,241.22 / $10,431.19 / $20,928.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,416.80 / $9,302.56 / $16,325.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,243.86 / $2,114.58 / $3,319.34
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,498.96 / $3,034.91 / $4,296.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,054.00 / $4,317.00 / $13,909.00