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Utah rates for HCPCS 93990

Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $123.03 / $123.03
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$15.14 / $15.14 / $15.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $134.90 / $331.13
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$11.75 / $22.91 / $53.70
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$95.50 / $112.20 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $223.87 / $309.03
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$16.60 / $26.30 / $43.65
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$120.23 / $190.55 / $269.15
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $104.71
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $208.93 / $295.12
Regence BlueShield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$20.89 / $29.51 / $45.71
Regence BlueShield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$134.90 / $177.83 / $275.42
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $257.04 / $380.19
Select Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$20.89 / $41.69 / $57.54
Select Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$97.72 / $213.80 / $316.23
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $173.78 / $239.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $181.97 / $288.40
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$13.80 / $23.99 / $39.81
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$112.20 / $158.49 / $251.19