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Utah rates for HCPCS 51725

Simple cystometrogram (CMG) (eg, spinal manometer)

Facilitymedian $107 · 10th–90th $107–$1070%50%$107Professionalmedian $234 · 10th–90th $162–$5250%10%10th90th$234$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $234.42 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $275.42 / $446.68
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $56.23 / $363.08
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $354.81 / $398.11
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $371.54 / $426.58
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $194.98 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $263.03 / $436.52