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Utah rates for HCPCS 64809

Sympathectomy Thoracolumbar

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.29 / $3,038.00 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,087.04 / $1,202.29 / $5,464.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$913.30 / $1,304.38 / $2,397.19
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.09 / $694.92 / $1,058.02
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,782.05 / $2,051.64 / $3,124.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,312.00 / $2,446.00 / $13,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$789.26 / $1,064.88 / $1,722.60