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Indiana rates for HCPCS B4083

Stomach Tube - Levine Type (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130 4450)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.96 / $2.14 / $2.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.13 / $2.14 / $2.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.55 / $1.75 / $1.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.60 / $1.60 / $2.39
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.52 / $1.96 / $2.50
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.79 / $2.06 / $2.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.35 / $2.35 / $2.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.11 / $2.11 / $2.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.74 / $2.27 / $3.44