go back

Utah rates for HCPCS 80375

Drug/Substance Definitive Qual/Quant Nos 1-3

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.05 / $0.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.95 / $23.95 / $29.94
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.54 / $23.88 / $27.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.58 / $10.16 / $14.51