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Utah rates for HCPCS Q4174

Palingen Or Promatrx 0.36 Mg Per 0.25 Cc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,240.02 / $1,240.02 / $1,240.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,210.14 / $1,240.02 / $1,284.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,269.90 / $1,269.90 / $1,269.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,269.90 / $1,269.90 / $1,269.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $60.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,245.00 / $1,245.00 / $1,245.00