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Utah rates for HCPCS 19369

Breast Reconstruction Bipedicled Tram Flap

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,191.30 / $3,038.00 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,191.30 / $2,191.30 / $3,056.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,432.14 / $2,911.14 / $4,352.97
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.78 / $1,155.37 / $1,838.97
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,620.91 / $3,581.08 / $4,340.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,912.00 / $7,693.00 / $13,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,947.33 / $2,197.26 / $4,248.72