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Utah rates for HCPCS 90586

Bacillus Calmette-Guerin Vaccine Intravesical

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.97 / $162.97 / $162.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.97 / $162.97 / $162.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.88 / $224.05 / $373.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.81 / $203.81 / $203.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.83 / $184.17 / $195.58