go back

Utah rates for HCPCS 84081

Phosphatidylglycerol

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.93 / $109.67 / $143.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.22 / $14.04 / $20.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.12 / $14.53 / $45.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.44 / $19.00 / $23.75
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.52 / $19.00 / $74.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.65 / $13.57 / $19.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.94 / $6.94 / $9.91