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Utah rates for HCPCS 40804

Rmvl Embedded Fb Vestibule Mouth Smpl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.44 / $272.41 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.25 / $272.41 / $418.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.51 / $235.77 / $347.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.79 / $143.96 / $187.35
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,338.59 / $1,718.74 / $2,504.69
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.32 / $275.60 / $388.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,689.00 / $2,312.00 / $4,640.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.79 / $248.56 / $417.71