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Utah rates for HCPCS 12054

Repair Intermediate F/E/E/N/L&/Muc 7.6-12.5 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.69 / $2,744.00 / $4,626.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.71 / $271.02 / $588.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.19 / $363.30 / $598.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.49 / $276.95 / $373.56
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$571.79 / $756.04 / $1,101.77
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.17 / $401.12 / $562.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,078.00 / $1,556.00 / $4,495.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.51 / $383.12 / $553.24