go back

Utah rates for HCPCS A4707

Bicarbonate conc pow per pac

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.40 / $4.40 / $4.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $4.40 / $5.14
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $45.00 / $60.00