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Utah rates for HCPCS 64490

Njx Dx/Ther Agt Pvrt Facet Jt Crv/Thrc 1 Level

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.16 / $1,816.01 / $4,387.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$788.85 / $2,659.35 / $6,612.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.14 / $192.28 / $608.77
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$98.04 / $266.55 / $937.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.91 / $215.75 / $323.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.90 / $180.62 / $221.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,361.81 / $1,728.22 / $2,518.51
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,042.72 / $2,592.33 / $3,777.77
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.80 / $302.68 / $498.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,106.00 / $1,649.00 / $2,824.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.82 / $202.37 / $327.05