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Utah rates for HCPCS L8642

Hallux Implant (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.76 / $109.76 / $109.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.76 / $134.69 / $1,199.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.83 / $302.83 / $302.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.41 / $302.83 / $435.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $267.68 / $347.98
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.92 / $256.67 / $385.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.68 / $226.68 / $256.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.50 / $170.01 / $243.90