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Utah rates for HCPCS 19380

Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$814.50 / $5,499.88 / $9,187.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,360.78 / $5,225.64 / $14,490.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,155.27 / $12,364.35 / $18,018.40
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$13,732.91 / $18,546.53 / $27,027.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,912.00 / $7,693.00 / $13,847.00