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Utah rates for HCPCS 25115

Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); flexors

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $6,025.60 / $8,709.64
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $2,691.53 / $6,025.60
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,230.27 / $1,862.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $5,128.61 / $7,079.46