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Utah rates for HCPCS 21400

Clsd Tx Fx Orbit Except Blowout W/O Manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$209.54 / $3,038.00 / $4,626.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.08 / $209.54 / $852.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.93 / $232.88 / $403.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.59 / $130.10 / $215.58
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$765.38 / $1,043.22 / $1,520.27
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.41 / $320.08 / $470.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,078.00 / $1,556.00 / $4,495.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.05 / $203.50 / $337.20