go back

Utah rates for HCPCS 14021

Adjt/Rearrgmt Scalp/Arm/Leg 10.1-30.0 Sq Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$771.28 / $3,977.00 / $8,659.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.64 / $771.28 / $1,411.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$784.45 / $1,030.68 / $1,365.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.08 / $517.68 / $797.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,814.80 / $3,509.81 / $5,038.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$784.86 / $964.94 / $1,413.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,689.00 / $2,312.00 / $4,640.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.11 / $888.89 / $1,343.16