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Utah rates for HCPCS 12004

Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm

Facilitymedian $871 · 10th–90th $302–$4,4670%10%20%10th90th$871Professionalmedian $129 · 10th–90th $68–$2820%10%10th90th$129$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $870.96 / $4,265.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $128.82 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $158.49 / $218.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $446.68
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $389.05 / $588.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $141.25 / $223.87
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $154.88 / $239.88
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $169.82 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $117.49 / $199.53