| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $158.49 | $3,162.28 | $4,570.88 | |
U of Utah Health Plan
| Professional | $144.54 | $177.83 | $257.04 | |
United
| Facility | $1,698.24 | $4,466.84 | $5,128.61 |
Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote chest exit site (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $158.49 | $3,162.28 | $4,570.88 | |
U of Utah Health Plan
| Professional | $144.54 | $177.83 | $257.04 | |
United
| Facility | $1,698.24 | $4,466.84 | $5,128.61 |