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Arizona rates for HCPCS 64400

Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular)

Facilitymedian $1,660 · 10th–90th $182–$4,7860%5%10th90th$1,660Professionalmedian $115 · 10th–90th $51–$4270%5%10%10th90th$115$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$870.96 / $2,089.30 / $5,623.41
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,398.83 / $3,162.28 / $3,162.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $112.20 / $323.59
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$144.54 / $426.58 / $933.25
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $562.34 / $1,071.52
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $79.43 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $109.65 / $199.53
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $117.49 / $1,288.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $144.54 / $1,023.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $933.25 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $95.50 / $165.96