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Utah rates for HCPCS 12055

Repair Intermediate F/E/E/N/L&/Muc 12.6-20.0cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$287.27 / $3,038.00 / $4,626.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.28 / $325.88 / $767.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.68 / $495.50 / $786.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.59 / $377.74 / $501.12
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
$333.95 / $534.79 / $729.21
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
$388.12 / $501.12 / $709.92