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Utah rates for HCPCS 43622

Gstrct Tot W/Frmj Intstinal Pouch Any Type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,038.00 / $3,043.48 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,115.42 / $3,043.48 / $6,613.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,935.37 / $3,192.22 / $4,413.43
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.17 / $1,651.98 / $2,201.82
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,006.02 / $3,835.96 / $4,879.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,312.00 / $2,446.00 / $13,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,025.89 / $2,660.81 / $4,456.97