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Utah rates for HCPCS 15842

Graft for facial nerve paralysis; free muscle flap by microsurgical technique

Facilitymedian $4,571 · 10th–90th $2,692–$8,7100%10%10th90th$4,571Professionalmedian $2,692 · 10th–90th $2,291–$5,7540%20%10th90th$2,692$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
$2,691.53 / $6,025.60 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,691.53 / $5,011.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,388.44 / $4,466.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $8,317.64
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
$2,951.21 / $3,981.07 / $6,165.95
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,715.35 / $7,244.36
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $3,467.37 / $5,754.40
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
$2,137.96 / $2,754.23 / $4,073.80