go back

Utah rates for HCPCS 33764

Shunt Central W/Prosthetic Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,971.59 / $3,038.00 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,176.33 / $1,971.59 / $3,903.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.42 / $1,851.82 / $2,436.81
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.79 / $959.42 / $1,295.76
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,700.13 / $2,301.67 / $2,874.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,312.00 / $2,446.00 / $13,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,256.31 / $1,471.74 / $2,741.04