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Utah rates for HCPCS 74775

Perineogram

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.34 / $199.34 / $1,101.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.15 / $199.34 / $464.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.61 / $310.27 / $982.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.65 / $115.87 / $183.62
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $38.81 / $148.76
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$378.22 / $480.81 / $767.88
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.96 / $151.52 / $181.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.95 / $264.89 / $437.09