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Utah rates for HCPCS 14021

Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm

Facilitymedian $4,571 · 10th–90th $776–$8,7100%10%10th90th$4,571Professionalmedian $832 · 10th–90th $617–$1,7780%10%20%10th90th$832$50.0$200.0$1.0K$5.0K

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
$776.25 / $5,888.44 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $794.33 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,071.52 / $1,380.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $2,630.27
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,548.13 / $5,495.41
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,071.52 / $1,905.46
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,348.96 / $2,089.30
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,071.52 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $831.76 / $1,230.27