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Utah rates for HCPCS 23525

Closed treatment of sternoclavicular dislocation; with manipulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $457.09 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $467.74 / $851.14
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $660.69
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $398.11 / $870.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $676.08 / $912.01
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $676.08 / $851.14
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $616.60 / $851.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $389.05 / $602.56