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Utah rates for HCPCS 81504

Oncology Tissue Of Origin Similar Scor Algorithm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,732.67 / $1,732.67 / $1,732.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.00 / $468.00 / $468.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$444.47 / $457.14 / $1,432.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.90 / $558.40 / $951.36
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$520.00 / $598.00 / $2,106.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$511.37 / $560.91 / $623.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.40 / $218.40 / $312.00