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Utah rates for HCPCS 49605

Repair of large omphalocele or gastroschisis; with or without prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $6,025.60 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $5,370.32 / $13,803.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $6,456.54 / $10,232.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $10,715.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,309.57 / $8,128.31 / $10,715.19
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $8,912.51 / $12,589.25
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,025.60 / $7,244.36 / $10,232.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $5,370.32 / $8,709.64