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Utah rates for HCPCS 69604

Revj Mastoidectomy Rsltg Tympanoplasty

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,282.79 / $4,387.00 / $9,932.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,282.79 / $1,282.79 / $1,997.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,294.81 / $1,628.04 / $2,408.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.01 / $710.57 / $1,026.06
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,413.68 / $11,103.62 / $16,181.16
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,459.93 / $1,928.55 / $2,149.89
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
$1,005.12 / $1,139.34 / $2,273.04