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Utah rates for HCPCS G0101

Cervical Or Vaginal Cancer Screening; Pelvic And Clinical Breast Examination (Special Coverage Instructions Apply)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.68 / $33.68 / $45.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.80 / $36.01 / $68.77
Aetna
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$41.27 / $41.27 / $144.00
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$11.04 / $16.84 / $22.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.82 / $34.82 / $34.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.09 / $29.37 / $38.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.52 / $41.46 / $55.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.60 / $44.07 / $67.80