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Utah rates for HCPCS 25315

Flexor origin slide (eg, for cerebral palsy, Volkmann contracture), forearm and/or wrist;

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $5,888.44 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,047.13 / $4,265.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,071.52 / $1,698.24
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $588.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,471.29 / $12,302.69 / $28,183.83
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,479.11 / $2,137.96
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,412.54 / $1,862.09
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,258.93 / $1,819.70
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
$660.69 / $831.76 / $1,318.26