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Utah rates for HCPCS 86759

Antibody; rotavirus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $56.23 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $14.13 / $19.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $15.85 / $50.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $20.42 / $25.70
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.20 / $33.11 / $87.10
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.30 / $15.49 / $16.22
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $18.20 / $57.54
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.71 / $16.22 / $22.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.12 / $9.12 / $11.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $7.76 / $18.20