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Indiana rates for HCPCS L8041

Midfacial prosthesis, provided by a nonphysician

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,716.63 / $1,716.63 / $3,607.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,716.63 / $1,750.96 / $1,790.32
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,849.58 / $3,228.32 / $3,607.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,716.79 / $1,970.30 / $2,719.01
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,442.85 / $3,426.66 / $4,869.53
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,514.99 / $3,597.99 / $4,625.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,861.13 / $2,861.13 / $3,607.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,431.96 / $2,861.13 / $3,656.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,070.78 / $1,799.52 / $2,475.06