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Utah rates for HCPCS 49426

Revision of peritoneal-venous shunt

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $3,715.35 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $707.95 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $831.76 / $1,412.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,318.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,248.07 / $6,165.95 / $15,135.61
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,047.13 / $1,348.96
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $1,230.27 / $1,698.24
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $977.24 / $1,380.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $5,128.61 / $8,317.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $724.44 / $1,148.15