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Utah rates for HCPCS 64505

Injection, anesthetic agent; sphenopalatine ganglion

Facilitymedian $3,020 · 10th–90th $138–$4,5710%10%10th90th$3,020Professionalmedian $155 · 10th–90th $91–$5620%10%10th90th$155$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $154.88 / $562.34
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$575.44 / $575.44 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $138.04 / $234.42
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $109.65
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $575.44 / $891.25
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$630.96 / $870.96 / $1,318.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $234.42 / $295.12
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $190.55 / $263.03
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $204.17 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $112.20 / $186.21