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Utah rates for HCPCS 95875

Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)

Professionalmedian $129 · 10th–90th $89–$2510%10%10th90th$129$20.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $131.83 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $158.49 / $257.04
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $128.82
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $177.83 / $257.04
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $194.98 / $251.19
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $100.00 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $144.54 / $208.93