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Utah rates for HCPCS 49426

Revis Peritoneal-Venous Shunt

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$846.43 / $3,064.00 / $4,707.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.65 / $846.43 / $1,927.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.00 / $906.11 / $1,377.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.28 / $480.68 / $639.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,263.30 / $6,648.17 / $9,559.39
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$880.31 / $1,045.47 / $1,337.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $6,097.00 / $8,267.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$601.60 / $863.85 / $1,443.10