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Utah rates for HCPCS 64681

Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus

Facilitymedian $3,236 · 10th–90th $525–$4,8980%10%10th90th$3,236Professionalmedian $479 · 10th–90th $219–$1,4450%5%10%10th90th$479$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
$524.81 / $3,388.44 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $478.63 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $380.19 / $794.33
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $380.19
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,737.80 / $2,691.53
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $645.65 / $1,000.00
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $501.19 / $812.83
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $630.96 / $870.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $2,818.38 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $371.54 / $691.83