go back

Utah rates for HCPCS 12053

Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $630.96 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $309.03 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $338.84 / $562.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $660.69
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $676.08 / $1,584.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $380.19 / $602.56
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $380.19 / $616.60
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $446.68 / $616.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $295.12 / $478.63