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Utah rates for HCPCS 22904

Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; less than 5 cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $3,715.35 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,096.48 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,445.44 / $2,137.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,905.46
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $4,570.88 / $10,964.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $2,187.76 / $2,630.27
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,905.46 / $2,570.40
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,698.24 / $2,290.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,258.93 / $2,187.76