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Utah rates for HCPCS 50400

Pyeloplasty Simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,640.64 / $3,038.00 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,133.06 / $1,640.64 / $2,619.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,390.29 / $1,643.62 / $2,499.80
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.79 / $835.84 / $1,114.46
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,494.74 / $2,247.39 / $2,643.99
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
$974.69 / $1,212.97 / $2,419.92