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Utah rates for HCPCS G2004

Comprehensive (60 minutes) in-home visit for a new patient postdischarge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than nine times.)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $190.55 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $147.91 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $141.25 / $177.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $223.87 / $275.42
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $181.97 / $281.84
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $218.78 / $302.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $204.17 / $281.84