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Utah rates for HCPCS 21275

Secondary Revision Orbitocraniofacial Rcnstj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,187.84 / $4,387.00 / $9,932.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$777.53 / $1,187.84 / $4,447.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$838.88 / $1,163.27 / $1,826.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.47 / $489.21 / $802.11
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
$1,103.98 / $1,378.07 / $2,096.71
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
$717.83 / $886.73 / $1,439.61