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Utah rates for HCPCS 57400

Dilation of vagina under anesthesia (other than local)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $3,715.35 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $134.90 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $181.97 / $288.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $309.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $5,128.61 / $12,022.64
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $223.87 / $288.40
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $204.17 / $275.42
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $199.53 / $288.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $5,128.61 / $7,079.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $154.88 / $275.42