go back

Utah rates for HCPCS 15004

Prep Site F/S/N/H/F/G/M/D Gt 1st 100 Sq Cm/1pct

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$289.31 / $2,356.00 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$224.90 / $338.34 / $906.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.06 / $408.85 / $614.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.43 / $375.79 / $462.52
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$873.66 / $1,190.82 / $1,735.36
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$284.50 / $433.94 / $622.44
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
$330.30 / $411.85 / $606.55