go back

Utah rates for HCPCS 78140

Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $1,230.27 / $1,230.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $114.82 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $512.86 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $190.55 / $229.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $60.26 / $229.09
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,230.27 / $1,698.24
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $269.15 / $288.40
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $165.96 / $269.15
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $134.90 / $213.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $131.83 / $194.98