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Utah rates for HCPCS 40654

Repair lip, full thickness; over one-half vertical height, or complex

Facilitymedian $4,571 · 10th–90th $741–$7,9430%10%10th90th$4,571Professionalmedian $603 · 10th–90th $437–$1,2300%20%10th90th$603$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
$741.31 / $4,570.88 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $588.84 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $660.69 / $912.01
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,000.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,884.03 / $4,466.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $812.83 / $1,071.52
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $954.99 / $1,348.96
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $741.31 / $1,023.29
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
$371.54 / $524.81 / $831.76