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Utah rates for HCPCS Q4234

XCellerate, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$642.55 / $642.55 / $642.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.94 / $609.33 / $692.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$298.45 / $353.86 / $589.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.94 / $553.94 / $553.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.40 / $609.33 / $609.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.94 / $553.94 / $553.94