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Utah rates for HCPCS 20696

Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; initial and subsequent alignment(s), assessment(s), and computation(s) of adjustment schedule(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $5,888.44 / $8,511.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,915.35 / $31,622.78 / $93,325.43
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,949.84 / $2,818.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $5,128.61 / $8,317.64