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Utah rates for HCPCS 80200

Tobramycin

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.95 / $109.65 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $12.88 / $19.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.80 / $14.13 / $44.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.23 / $18.62 / $30.90
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $58.88 / $85.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $13.80 / $14.45
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.22 / $16.22 / $51.29
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $16.22 / $30.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.13 / $8.13 / $10.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $9.55 / $22.39