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Indiana rates for HCPCS 49905

Omental flap, intra-abdominal (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $4,897.79 / $5,370.32
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $14,125.38 / $19,054.61
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $338.84 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $602.56 / $758.58
Cigna
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$371.54 / $371.54 / $371.54
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$60.26 / $60.26 / $60.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $10,000.00 / $15,848.93