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Utah rates for HCPCS 21195

Rcnstj Mndblr Rami&/Body Sgtl Splt W/O Int Rgd

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,900.84 / $4,387.00 / $9,078.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,238.90 / $1,900.84 / $7,347.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,349.41 / $1,918.69 / $2,878.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.95 / $783.86 / $1,247.56
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
$1,737.99 / $2,215.30 / $3,377.42
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
$1,156.33 / $1,423.44 / $2,293.31