go back

Utah rates for HCPCS 84255

Selenium

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $66.07 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $22.39 / $30.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $22.39 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $29.51 / $48.98
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $93.33 / $134.90
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $21.88 / $22.91
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.78 / $25.70 / $81.28
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.39 / $25.70 / $48.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $12.88 / $89.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.72 / $15.14 / $35.48