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Utah rates for HCPCS 61791

Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract

Facilitymedian $4,571 · 10th–90th $2,818–$8,5110%10%10th90th$4,571Professionalmedian $1,380 · 10th–90th $1,000–$3,3110%20%10th90th$1,380$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
$1,584.89 / $5,888.44 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,174.90 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,584.89 / $2,398.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $3,235.94
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,801.89 / $5,888.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,630.27 / $3,311.31
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,691.53 / $3,467.37
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,905.46 / $4,365.16
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $7,079.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,348.96 / $2,344.23