go back

Utah rates for HCPCS 21110

Appl Interdental Fixation Device Non-Fx/Dislc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$903.15 / $2,910.00 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$677.10 / $903.15 / $3,943.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$722.31 / $993.30 / $1,565.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.31 / $485.33 / $797.56
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,237.82 / $2,891.57 / $4,213.85
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$950.96 / $1,282.38 / $1,917.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$871.00 / $4,455.00 / $4,912.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$696.88 / $861.73 / $1,390.80