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Utah rates for HCPCS A6412

Eye Patch Occlusive Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.15 / $0.15 / $0.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.26 / $0.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.27
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
$0.36 / $0.36 / $0.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.22 / $0.36