go back

Tennessee 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
$2,258.00 / $2,738.39 / $7,602.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,031.00 / $2,267.00 / $4,235.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.00 / $525.00 / $2,277.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $21,890.68 / $22,535.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.00 / $2,397.00 / $4,544.00