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Utah rates for HCPCS 21215

Graft Bone Mandible

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,270.10 / $5,182.07 / $9,932.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$740.80 / $3,374.21 / $8,572.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$973.97 / $3,429.81 / $6,995.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.42 / $2,359.25 / $3,603.59
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
$1,040.25 / $2,478.79 / $9,690.96
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
$3,401.72 / $4,340.12 / $6,920.70