go back

Utah rates for HCPCS 41805

Removal of embedded foreign body from dentoalveolar structures; soft tissues

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $288.40 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $309.03 / $537.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $398.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $2,630.27 / $5,888.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $380.19 / $537.03
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $363.08 / $562.34
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $389.05 / $588.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $257.04 / $436.52