go back

Utah rates for HCPCS 66174

Trluml Dilat Aqueous O/F Can Wo Retention Dev/St

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,032.32 / $4,387.00 / $9,078.00
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$774.24 / $774.24 / $774.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$757.69 / $1,032.32 / $1,608.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$719.97 / $1,098.29 / $1,446.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.10 / $326.63 / $567.39
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,275.72 / $7,825.28 / $11,234.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$808.07 / $955.91 / $2,034.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,912.00 / $7,693.00 / $13,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$809.78 / $963.72 / $1,445.50