go back

Utah rates for HCPCS 0102T

Extracorporeal shock wave performed by a physician, requiring anesthesia other than local, and involving the lateral humeral epicondyle

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $338.84 / $436.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $44.67 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $5,495.41 / $12,589.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $407.38 / $501.19
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $208.93 / $316.23
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $436.52 / $512.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $5,128.61 / $8,317.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $316.23 / $467.74