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Utah rates for HCPCS C2622

Prosthesis, Penile, Non-Inf

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,989.95 / $3,989.95 / $3,989.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,768.95 / $3,989.95 / $3,989.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $45.00