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Utah rates for HCPCS 21355

Percutaneous treatment of fracture of malar area, including zygomatic arch and malar tripod, with manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $4,570.88 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $467.74 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $489.78 / $891.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $616.60
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $5,370.32 / $12,022.64
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $660.69 / $1,071.52
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $630.96 / $851.14
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $616.60 / $977.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $416.87 / $630.96