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Utah rates for HCPCS 63195

Laminectomy with cordotomy, with section of 1 spinothalamic tract, 1 stage; thoracic

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,999.70 / $3,999.70 / $4,395.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,290.25 / $4,290.25 / $4,689.43