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Utah rates for HCPCS L8612

Aqueous Shunt (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$235.05 / $235.05 / $544.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.05 / $588.83 / $2,755.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$451.71 / $451.71 / $451.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$383.95 / $451.70 / $1,107.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $589.38 / $766.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$448.96 / $565.14 / $847.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.73 / $364.09 / $522.33