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Utah rates for HCPCS A4570

Splint (Not Valid For Medicare)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.36 / $5.36 / $42.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.36 / $5.89 / $31.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.45 / $7.45 / $7.45
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.83 / $30.56 / $60.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.03 / $16.66 / $21.35
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.74 / $12.74 / $12.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.05 / $7.58 / $12.62