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Utah rates for HCPCS 21245

Rcnstj Mndbl/Maxl Subpriosteal Implant Partial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,281.89 / $3,294.00 / $9,932.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$845.39 / $1,181.76 / $4,979.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$952.60 / $1,419.99 / $2,246.46
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.08 / $706.44 / $1,104.56
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
$1,254.33 / $1,776.41 / $2,706.29
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
$1,012.17 / $1,216.99 / $2,005.64