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Utah rates for HCPCS 21261

Periorbital Osteotomies W/Bone Grafts Icra & Xtr

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,038.00 / $3,143.92 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,234.25 / $3,143.92 / $12,969.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,280.63 / $3,177.43 / $5,224.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.06 / $1,376.06 / $2,232.91
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
$3,156.58 / $3,793.84 / $5,083.59
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
$1,946.25 / $2,489.19 / $3,911.58