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Utah rates for HCPCS 50520

Closure Nephrocutaneous/Pyelocutaneous Fistula

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,463.45 / $3,038.00 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,463.45 / $1,463.45 / $2,577.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,376.42 / $1,603.20 / $2,523.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.79 / $830.17 / $1,106.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,517.36 / $2,099.19 / $2,403.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$658.00 / $2,790.00 / $4,912.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,046.24 / $1,218.02 / $2,429.98