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Utah rates for HCPCS 65290

Repair of wound, extraocular muscle, tendon and/or Tenon's capsule

Facilitymedian $5,888 · 10th–90th $3,162–$8,9130%10%10th90th$5,888Professionalmedian $525 · 10th–90th $457–$1,0470%20%10th90th$525$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
$512.86 / $5,888.44 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $512.86 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $660.69 / $870.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $363.08
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $7,413.10 / $11,220.18
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $758.58 / $1,071.52
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $758.58 / $1,000.00
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $724.44 / $2,089.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $8,317.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $489.78 / $812.83