go back

California rates for HCPCS 64400

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219.62 / $3,222.00 / $15,277.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$677.30 / $1,431.00 / $7,709.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.59 / $108.57 / $285.25
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$54.53 / $276.95 / $927.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.00 / $146.00 / $156.65
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$219.01 / $219.01 / $219.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,882.00 / $4,505.00 / $8,976.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.63 / $75.84 / $141.61
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$82.24 / $107.71 / $201.32
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.00 / $4,979.42
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.05 / $107.57 / $199.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.10 / $153.37 / $1,487.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.38 / $121.94 / $236.62
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.59 / $68.90 / $154.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.32 / $115.86 / $215.32
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $237.65 / $254.27
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$804.00 / $1,030.00 / $1,030.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.96 / $111.30 / $189.05
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.31 / $126.58 / $271.33
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.34 / $159.34 / $352.89
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.90 / $79.23 / $155.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$510.00 / $1,495.00 / $6,920.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.40 / $115.90 / $246.49