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Texas 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
$945.00 / $3,570.00 / $10,893.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,442.36 / $2,351.91 / $6,067.02
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,257.63 / $1,257.63 / $1,294.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.00 / $2,024.00 / $4,619.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $55.00 / $21,890.68
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,321.19 / $1,705.30 / $3,040.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,325.24 / $1,715.14 / $3,203.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$385.00 / $1,970.00 / $8,583.00