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Utah rates for HCPCS 27105

Transfer paraspinal muscle to hip (includes fascial or tendon extension graft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $6,025.60 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,174.90 / $4,786.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,174.90 / $1,862.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $660.69
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $5,495.41 / $12,589.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,659.59 / $2,137.96
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,621.81 / $2,089.30
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,348.96 / $1,949.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $912.01 / $1,380.38