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Illinois rates for HCPCS L8049

Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a nonphysician

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.36 / $28.36 / $28.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.36 / $28.36 / $50.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.44 / $45.28 / $161.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.60 / $12.60 / $12.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.71 / $10.71 / $12.98
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $200.00 / $345.40
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.04 / $13.25 / $27.60