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Utah rates for HCPCS 57400

Dilation Vagina W/Anesthesia Other Than Local

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.44 / $3,084.00 / $4,707.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.09 / $174.44 / $226.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.08 / $186.12 / $290.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.00 / $85.26 / $113.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,349.00 / $5,927.75 / $8,638.43
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.15 / $231.78 / $285.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,981.00 / $3,613.00 / $7,048.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.73 / $137.50 / $274.32