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Utah rates for HCPCS 64555

Prq Impltj Neurostimulator Eltrd Peripheral Nrv

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.44 / $2,910.00 / $5,743.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.94 / $507.11 / $3,762.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.71 / $392.70 / $3,612.46
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.25 / $1,492.54 / $1,996.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,197.37 / $12,967.40 / $18,897.21
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.88 / $559.13 / $3,915.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,028.00 / $9,753.00 / $75,254.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.68 / $1,597.49 / $2,928.74