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Utah rates for HCPCS 42810

Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $4,570.88 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $389.05 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $436.52 / $758.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $602.56
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $5,370.32 / $12,022.64
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $549.54 / $758.58
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $549.54 / $741.31
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $501.19 / $724.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $5,128.61 / $7,079.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $380.19 / $630.96