go back

Utah rates for HCPCS 41870

Periodontal mucosal grafting

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $3,715.35 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $323.59 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $407.38 / $645.65
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $190.55 / $758.58
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
$398.11 / $501.19 / $676.08
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $954.99
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $457.09 / $478.63
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
$263.03 / $338.84 / $549.54