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Utah rates for HCPCS C2622

Prosthesis, penile, noninflatable

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.07 / $3,981.07 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,801.89 / $3,981.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $44.67