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Utah rates for HCPCS 41870

Periodontal mucosal grafting

Facilitymedian $3,548 · 10th–90th $1,698–$4,8980%10%20%10th90th$3,548Professionalmedian $331 · 10th–90th $282–$5370%20%10th90th$331$50.0$100.0$200.0$500.0$1.0K$2.0K$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
$416.87 / $3,715.35 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $323.59 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $398.11 / $645.65
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $190.55 / $758.58
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
$398.11 / $489.78 / $676.08
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $954.99 / $954.99
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $457.09 / $812.83
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
$263.03 / $338.84 / $549.54