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Utah rates for HCPCS 96375

Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $25.12 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $29.51 / $30.90
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.79 / $24.55 / $32.36
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $21.88 / $25.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $23.44 / $31.62