go back

Utah rates for HCPCS 90967

End-stage renal disease (ESRD) related services for dialysis less than a full month of service, per day; for patients younger than 2 years of age

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.72 / $21.72 / $21.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.94 / $19.80 / $24.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.32 / $25.76 / $33.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.20 / $30.82 / $100.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.93 / $26.44 / $34.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.58 / $20.35 / $30.28