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Maine 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
$141.25 / $426.58 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $112.20 / $223.87
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$54.95 / $162.18 / $407.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $79.43 / $123.03
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$70.79 / $117.49 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $131.83 / $229.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $151.36 / $239.88
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $426.58 / $691.83
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $120.23 / $234.42
Martin's Point
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$54.95 / $165.96 / $407.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $107.15 / $229.09