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Utah rates for HCPCS 33677

Closure of multiple ventricular septal defects; with removal of pulmonary artery band, with or without gusset

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,511.89 / $3,162.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $3,090.30 / $3,890.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $60.26 / $13,489.63
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $4,466.84 / $12,589.25
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $4,897.79 / $6,606.93
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $3,311.31 / $11,220.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,691.53 / $4,365.16