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Utah rates for HCPCS 17004

Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $3,019.95 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $158.49 / $380.19
Aetna
Facility/Professional
Professional
Modifier
22
Low / Median / High Price
$794.33 / $794.33 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $181.97 / $257.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $691.83
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $676.08 / $1,584.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $173.78 / $251.19
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $173.78 / $288.40
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $199.53 / $323.59
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
$91.20 / $141.25 / $218.78