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Utah rates for HCPCS 64755

Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,287.32 / $3,038.00 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$927.36 / $1,287.32 / $4,747.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$922.50 / $1,274.89 / $1,952.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.28 / $654.91 / $884.06
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.04 / $1,704.17 / $2,563.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,312.00 / $2,446.00 / $13,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$784.04 / $960.49 / $1,540.98