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Utah rates for HCPCS 40801

Drg Absc Cst Hmtma Vestibule Mouth Comp

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$292.04 / $3,038.00 / $4,626.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.97 / $403.50 / $576.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.57 / $355.24 / $536.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.54 / $204.94 / $286.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$765.38 / $1,043.22 / $1,520.27
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.13 / $424.03 / $581.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,078.00 / $1,556.00 / $4,495.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$283.47 / $319.55 / $618.48