go back

Maine rates for HCPCS 64400

Injection Aa&/Strd Trigeminal Nerve Each Branch

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$197.62 / $425.35 / $524.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.59 / $86.19 / $136.63
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.84 / $68.05 / $102.88
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$86.77 / $102.08 / $154.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.62 / $126.23 / $226.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.72 / $138.91 / $223.01
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$207.34 / $438.49 / $695.62
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.77 / $94.92 / $145.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.34 / $161.58 / $229.34