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Utah rates for HCPCS 76514

Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $48.98 / $575.44
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$10.00 / $10.00 / $10.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $13.18 / $36.31
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$6.03 / $8.32 / $45.71
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$11.48 / $11.48 / $12.30
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$2.00 / $3.89 / $6.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.01 / $31.62 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $16.98 / $24.55
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$8.13 / $11.75 / $16.98
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$3.09 / $5.50 / $8.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $77.62 / $114.82
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$44.67 / $44.67 / $44.67
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.85 / $23.99 / $31.62
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$10.72 / $15.85 / $20.89
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$5.13 / $8.13 / $10.72
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $17.78 / $26.30
Select Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$7.41 / $12.02 / $17.78
Select Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$3.72 / $5.50 / $8.13
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.13 / $12.30 / $20.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.22 / $12.88 / $20.42
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$7.76 / $9.12 / $13.80
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$3.63 / $4.17 / $6.61