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Utah rates for HCPCS 35103

Dir Rpr Ruptd Aneurysm Abdom Aorta W/Iliac Vsls

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,038.00 / $3,531.40 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,531.40 / $3,531.40 / $6,532.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,026.98 / $3,204.20 / $3,604.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.83 / $1,423.98 / $2,035.43
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,821.95 / $4,368.34 / $5,139.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,292.00 / $4,455.00 / $13,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,146.32 / $2,638.01 / $4,682.89