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Utah rates for HCPCS L6624

Upper Extremi Addi, Flexion/Extens And Rotation Wrist Unit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,308.09 / $1,308.09 / $1,308.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,308.09 / $1,437.69 / $12,803.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,941.06 / $2,941.06 / $2,941.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,146.96 / $2,146.96 / $5,323.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,080.38 / $3,355.46 / $4,362.09
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,024.73 / $4,488.63 / $4,488.63
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,555.98 / $3,217.45 / $4,826.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,829.51 / $2,026.24 / $2,906.89