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Utah rates for HCPCS 80198

Theophylline

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.98 / $95.50 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $10.96 / $16.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.02 / $12.30 / $38.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $16.60 / $27.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $51.29 / $74.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.55 / $12.02 / $12.59
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $14.13 / $44.67
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.30 / $14.13 / $26.92
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $7.08 / $9.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $8.32 / $15.14