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Utah rates for HCPCS 21147

Rcnstj Midface Lefort I 3/> Piece W/Bone Grafts

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,314.29 / $5,743.00 / $9,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,421.81 / $1,683.03 / $9,141.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,620.60 / $2,407.98 / $3,666.67
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.78 / $971.43 / $1,570.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,238.37 / $10,273.82 / $14,749.55
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,207.08 / $2,908.70 / $4,546.16
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
$1,482.59 / $1,822.69 / $2,982.01