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Utah rates for HCPCS 0122U

Sickle cell disease, microfluidic flow adhesion (P-Selectin), whole blood

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $2,570.40 / $3,311.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $416.87 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $467.74 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $602.56 / $758.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $44.67
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $630.96 / $2,454.71
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $446.68 / $467.74
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $524.81 / $1,513.56
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $467.74 / $794.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $263.03 / $338.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $218.78 / $416.87