go back

Utah rates for HCPCS 0100T

Plmt Scjncl Rta Prosth&Pls&Impltj Intra-Oc Rta

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,025.06 / $4,387.00 / $9,932.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.22 / $2,025.06 / $2,025.06
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $45.00 / $60.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,898.59 / $2,728.97 / $3,691.53
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,773.00 / $2,083.14 / $2,853.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,425.00 / $21,844.00 / $43,473.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,525.79 / $1,871.12 / $2,824.89