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Utah rates for HCPCS 25490

Proph Tx N/P/Pltwr W/Wo Methylacrylate Radius

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$984.23 / $4,387.00 / $8,133.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$664.54 / $984.23 / $3,766.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$684.96 / $989.06 / $1,575.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.47 / $438.29 / $685.42
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,361.94 / $13,564.50 / $19,767.36
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$953.42 / $1,185.21 / $1,573.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,912.00 / $7,693.00 / $13,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$601.46 / $764.05 / $1,223.66