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Utah rates for HCPCS Q4113

Graftjacket Xpress

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$744.93 / $744.93 / $744.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$726.98 / $744.93 / $771.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$762.88 / $762.88 / $762.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$762.88 / $762.88 / $762.88
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $328.94 / $359.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,997.50 / $1,997.50 / $1,997.50