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Utah rates for HCPCS Q2004

Irrigation solution for treatment of bladder calculi, for example renacidin, per 500 ml

Facilitymedian $100 · 10th–90th $100–$1000%50%$100Professionalmedian $100 · 10th–90th $95–$1200%20%40%10th90th$100$10.0$20.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $100.00 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $281.84 / $302.00
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $112.20 / $114.82
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.31 / $7.76 / $7.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33