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Utah rates for HCPCS 13133

Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; each additional 5 cm or less (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $3,388.44 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $154.88 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $194.98 / $263.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $407.38
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $208.93 / $288.40
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $190.55 / $323.59
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $213.80 / $288.40
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
$112.20 / $154.88 / $245.47