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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)

Facilitymedian $427 · 10th–90th $141–$7240%20%10th90th$427Professionalmedian $117 · 10th–90th $58–$2400%10%10th90th$117$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$141.25 / $426.58 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $114.82 / $208.93
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$346.74 / $346.74 / $407.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $79.43 / $123.03
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$70.79 / $117.49 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $131.83 / $234.42
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $151.36 / $239.88
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $6,456.54 / $16,982.44
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $112.20 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $109.65 / $234.42