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Utah rates for HCPCS 76831

Saline infusion sonohysterography (SIS), including color flow Doppler, when performed

Facilitymedian $39 · 10th–90th $39–$390%50%$39Professionalmedian $138 · 10th–90th $98–$4900%10%10th90th$138$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$38.90 / $38.90 / $38.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $138.04 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $154.88 / $245.47
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $208.93 / $245.47
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $173.78 / $251.19
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $112.20 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $123.03 / $199.53