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Utah rates for HCPCS 99486

Supervision by a control physician of interfacility transport care of the critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with transport team before transport, at the referring facility and during the transport, including data interpretation and report; each additional 30 minutes (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.07 / $66.07 / $66.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $56.23 / $81.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $87.10 / $154.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $89.13 / $165.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $83.18 / $109.65
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $74.13 / $104.71
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $87.10 / $125.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $74.13 / $120.23