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Utah rates for HCPCS Q4074

Iloprost Non-Comp Unit Dose

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.34 / $184.34 / $345.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.34 / $184.34 / $486.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.91 / $195.79 / $225.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.58 / $158.91 / $189.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.23 / $148.76 / $193.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.33 / $210.40 / $255.29
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.81 / $174.81 / $190.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.97 / $158.91 / $158.91