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Utah rates for HCPCS 11976

Removal Implantable Contraceptive Capsules

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.25 / $2,910.00 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.44 / $125.11 / $234.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.91 / $160.61 / $228.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.37 / $122.33 / $150.06
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,029.45 / $1,334.02 / $1,944.04
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.21 / $161.00 / $221.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,106.00 / $1,649.00 / $2,824.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.35 / $149.40 / $240.70