go back

Utah rates for HCPCS 74775

Perineogram (eg, vaginogram, for sex determination or extent of anomalies)

Facilitymedian $589 · 10th–90th $200–$7240%20%40%10th90th$589Professionalmedian $204 · 10th–90th $50–$3310%10%20%10th90th$204$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$199.53 / $724.44 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $234.42 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $309.03 / $1,949.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $114.82 / $169.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $147.91
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $501.19 / $933.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $134.90 / $190.55
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $46.77 / $83.18
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $72.44 / $134.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $251.19 / $407.38