go back

Utah rates for HCPCS 15572

Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs

Facilitymedian $5,248 · 10th–90th $912–$8,9130%10%10th90th$5,248Professionalmedian $851 · 10th–90th $646–$1,6600%20%10th90th$851$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
$912.01 / $4,570.88 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $812.83 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,071.52 / $1,380.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $3,388.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,248.07 / $7,244.36 / $10,964.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,122.02 / $1,949.84
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,584.89 / $2,398.83
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,096.48 / $2,238.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $8,317.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $831.76 / $1,258.93