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Utah rates for HCPCS 99455

Work Related/Med Dblt Xm Treating Phys

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.20 / $125.20 / $125.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.19 / $84.95 / $125.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.50 / $40.50 / $40.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $45.00 / $60.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.64 / $55.16 / $71.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$233.00 / $233.00 / $233.00