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Utah rates for HCPCS 12057

Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $3,388.44 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $549.54 / $933.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $660.69 / $954.99
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $2,570.40
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
$467.74 / $676.08 / $954.99
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $676.08 / $1,023.29
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $758.58 / $1,174.90
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
$354.81 / $524.81 / $851.14