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Utah rates for HCPCS 14041

Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$837.89 / $3,977.00 / $7,568.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$657.13 / $840.01 / $1,498.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.81 / $1,124.80 / $1,454.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.31 / $554.19 / $862.44
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
$842.80 / $1,026.56 / $1,530.31
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
$764.73 / $951.68 / $1,455.00