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Utah rates for HCPCS 72255

Myelography, thoracic, radiological supervision and interpretation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $2,398.83 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $120.23 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $1,023.29 / $3,235.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $162.18 / $229.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $104.71
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $2,398.83 / $3,388.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $199.53 / $269.15
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $162.18 / $229.09
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $104.71 / $208.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $125.89 / $218.78