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Utah rates for HCPCS D0367

cone beam CT capture and interpretation with field of view of both jaws; with or without cranium

Facilitymedian $224 · 10th–90th $224–$2240%50%100%$224Professionalmedian $186 · 10th–90th $135–$2240%20%10th90th$186$50.0$100.0$200.0

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
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $169.82 / $223.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $60.26
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $407.38 / $407.38
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $263.03 / $295.12