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Utah rates for HCPCS 15576

Frmj Direct/Tubed Pedicle W/Wotr E/N/E/L/Ntroral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$710.71 / $3,977.00 / $7,694.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$559.21 / $710.71 / $1,198.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$708.97 / $948.57 / $1,229.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.16 / $473.23 / $713.53
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
$716.60 / $866.78 / $1,567.00
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
$664.63 / $821.04 / $1,253.06