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Utah rates for HCPCS 78456

Acute Venous Thrombosis Imaging Peptide

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$270.35 / $270.35 / $270.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.35 / $270.35 / $270.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,370.41 / $1,675.77 / $5,305.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.70 / $384.72 / $607.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.99 / $203.21 / $274.63
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,161.82 / $2,732.92 / $4,232.76
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.80 / $621.86 / $661.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.56 / $318.31 / $529.20