go back

Utah rates for HCPCS A2009

Symphony, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.48 / $46.48 / $46.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.48 / $60.05 / $127.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.13 / $93.13 / $93.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.13 / $93.13 / $93.13
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
$93.32 / $109.79 / $109.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.30 / $91.30 / $91.30