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Utah rates for HCPCS 90396

Varicella-Zoster Immune Globulin Human Im

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,326.37 / $2,326.37 / $2,326.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,326.37 / $2,326.37 / $2,326.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,554.44 / $2,554.44 / $2,554.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,358.06 / $4,549.46 / $6,531.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,349.17 / $2,654.57 / $2,819.02