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Utah rates for HCPCS 20936

Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $3,467.37 / $12,882.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $251.19 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $169.82 / $269.15
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $218.78 / $741.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $199.53 / $309.03
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $588.84 / $588.84
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $190.55 / $288.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $5,128.61 / $8,317.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $134.90 / $208.93