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Utah rates for HCPCS 68850

Injection of contrast medium for dacryocystography

Facilitymedian $3,162 · 10th–90th $62–$4,5710%10%20%10th90th$3,162Professionalmedian $65 · 10th–90th $52–$1290%20%10th90th$65$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
$61.66 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $61.66 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $79.43 / $125.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $104.71
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $83.18 / $123.03
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $81.28 / $128.82
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $77.62 / $123.03
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
$51.29 / $66.07 / $112.20