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Utah rates for HCPCS 21172

Rcnstj Superior-Lateral Orbital Rim & Lower Fhd

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,534.78 / $4,387.00 / $9,078.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,801.52 / $2,534.78 / $10,514.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,991.32 / $2,615.58 / $4,623.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.69 / $1,188.78 / $1,961.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,413.68 / $11,103.62 / $16,181.16
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,800.19 / $3,342.49 / $4,415.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.00 / $7,693.00 / $13,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,631.07 / $2,142.05 / $3,555.34