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Utah rates for HCPCS 57155

Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy

Facilitymedian $3,715 · 10th–90th $417–$6,4570%10%10th90th$3,715Professionalmedian $363 · 10th–90th $229–$8130%10%10th90th$363$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
$416.87 / $3,388.44 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $346.74 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $478.63 / $660.69
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $512.86
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,079.46 / $9,772.37 / $14,791.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $575.44 / $794.33
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $478.63 / $776.25
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $524.81 / $707.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $5,128.61 / $10,232.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $436.52 / $794.33