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Utah rates for HCPCS 12054

Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $3,235.94 / $4,786.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $323.59 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $346.74 / $602.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,288.25
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
$245.47 / $398.11 / $645.65
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $398.11 / $691.83
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $478.63 / $741.31
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
$190.55 / $309.03 / $512.86