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Minnesota 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
$2.17 / $2.17 / $2.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.58 / $2.17 / $2.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.31 / $2.50 / $3.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.17 / $2.71 / $2.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.05 / $7.17 / $17.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.64 / $2.86
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $6.55 / $13.58
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.25 / $2.25 / $3.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.00 / $2.67 / $3.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $2.34 / $5.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.76 / $2.22 / $4.76