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Utah rates for HCPCS 64612

Chemodnrvtj Musc Musc Innervated Facial Nrv Unil

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$222.01 / $2,164.00 / $4,387.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$367.22 / $367.22 / $424.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.91 / $193.96 / $662.39
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$171.03 / $528.84 / $993.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.60 / $188.24 / $264.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.56 / $91.08 / $112.17
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.21 / $561.58 / $818.38
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$648.32 / $842.37 / $1,227.57
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.26 / $255.84 / $350.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,078.00 / $1,556.00 / $4,495.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.71 / $161.29 / $231.25