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Utah rates for HCPCS 43762

Perq Replacement Gtube Not Req Revj Gstrst Trc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.22 / $914.29 / $3,977.00
Aetna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$26.61 / $26.61 / $144.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.26 / $201.01 / $474.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.99 / $256.29 / $408.19
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.06 / $205.27 / $258.90
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$381.48 / $484.37 / $682.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.65 / $83.16 / $390.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$658.00 / $4,445.00 / $4,912.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.95 / $290.25 / $397.53