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Utah rates for HCPCS A4616

Tubing (Oxygen) Per Foot (Special Coverage Instructions Apply. See Cim: 60-4 And Mcm: 3312)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.05 / $0.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.05 / $0.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.04 / $0.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.04 / $0.06 / $60.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.05 / $0.06 / $0.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.03 / $0.04 / $0.06