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Utah rates for HCPCS 33504

Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass

Facilitymedian $4,169 · 10th–90th $2,239–$6,0260%20%10th90th$4,169Professionalmedian $2,239 · 10th–90th $1,413–$4,3650%10%20%10th90th$2,239$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
$2,238.72 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,659.59 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,137.96 / $2,691.53
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $1,096.48 / $9,332.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $3,162.28 / $8,709.64
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $3,388.44 / $4,570.88
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $2,344.23 / $7,244.36
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $4,466.84 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,862.09 / $3,090.30