go back

Utah rates for HCPCS 40701

Plstc Rpr Cl Lip/Nsl Dfrm Prim Bi 1 Stg Px

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,488.60 / $4,387.00 / $9,932.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,050.30 / $1,258.47 / $3,434.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,171.32 / $1,418.62 / $2,212.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.12 / $806.13 / $1,129.60
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,413.68 / $11,103.62 / $16,181.16
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,528.84 / $1,726.58 / $2,190.92
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
$937.07 / $1,224.35 / $1,989.42