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Utah rates for HCPCS 21725

Division Sternocleidomastoid Open W/Cast

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$751.27 / $4,387.00 / $8,133.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.93 / $751.27 / $2,837.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.50 / $741.40 / $1,156.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.47 / $329.21 / $497.94
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,029.45 / $1,334.02 / $1,944.04
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$719.74 / $883.88 / $1,360.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,106.00 / $1,649.00 / $2,824.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.99 / $580.32 / $915.30