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Utah rates for HCPCS 25145

Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $3,715.35 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $724.44 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $724.44 / $1,148.15
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $912.01
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $5,495.41 / $12,589.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $1,000.00 / $1,288.25
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $977.24 / $1,258.93
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $851.14 / $1,230.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $5,128.61 / $8,317.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $562.34 / $891.25