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Utah rates for HCPCS 25695

Open Treatment Lunate Dislocation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$885.17 / $3,534.00 / $21,966.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$587.73 / $885.17 / $3,325.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$635.36 / $882.80 / $1,392.14
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.47 / $370.06 / $608.09
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
$842.89 / $1,042.76 / $1,494.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,981.00 / $3,613.00 / $7,048.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.05 / $677.10 / $1,098.00