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Utah rates for HCPCS 49428

Ligation of peritoneal-venous shunt

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $467.74 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $575.44 / $912.01
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $707.95 / $954.99
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $794.33 / $1,096.48
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $630.96 / $870.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $478.63 / $831.76