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Utah rates for HCPCS A4257

Replacement lens shield cartridge for use with laser skin piercing device, each

Facilitymedian $4 · 10th–90th $4$180%50%90th$4Professionalmedian $11 · 10th–90th $5$240%10%20%10th90th$11$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.98 / $3.98 / $3.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $10.96 / $23.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $7.41 / $7.41
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $15.85 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $17.78 / $17.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $12.59 / $12.59
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $17.78 / $18.20
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $18.20 / $21.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $7.59 / $11.48