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Utah rates for HCPCS 77293

Respiratory motion management simulation (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$114.82 / $114.82 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $457.09 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$89.13 / $131.83 / $239.88
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$295.12 / $338.84 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $602.56 / $758.58
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$125.89 / $144.54 / $194.98
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$338.84 / $446.68 / $588.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $54.95 / $831.76
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $707.95 / $891.25
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$154.88 / $181.97 / $218.78
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$457.09 / $524.81 / $691.83
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $707.95 / $954.99
Select Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$100.00 / $194.98 / $234.42
Select Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$275.42 / $524.81 / $724.44
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $467.74 / $758.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $575.44 / $758.58
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$123.03 / $131.83 / $181.97
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$363.08 / $436.52 / $575.44