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Utah rates for HCPCS J0775

Injection, collagenase, clostridium histolyticum, 0.01 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $79.43 / $112.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $104.71 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $75.86 / $75.86
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $120.23 / $245.47
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $81.28 / $81.28
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $75.86 / $91.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $75.86 / $75.86