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Pennsylvania rates for HCPCS 64400

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

Facilitymedian $813 · 10th–90th $105–$5,8880%5%10th90th$813Professionalmedian $110 · 10th–90th $50–$3020%10%20%10th90th$110$1.0$10.0$100.0$1.0K$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
$102.33 / $812.83 / $6,165.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $107.15 / $275.42
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$54.95 / $275.42 / $831.76
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $79.43
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $4,897.79 / $7,762.47
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $60.26 / $125.89
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,258.93 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $112.20 / $234.42
Capital Blue Cross
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$162.18 / $169.82 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $107.15 / $204.17
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $199.53 / $251.19
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $144.54 / $199.53
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $758.58 / $1,348.96
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$977.24 / $2,691.53 / $2,754.23
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $75.86 / $117.49
Highmark BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $3,715.35 / $6,760.83
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $60.26 / $131.83
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $812.83 / $5,370.32
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $109.65 / $239.88
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $158.49 / $269.15
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $138.04 / $363.08
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $107.15 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $741.31 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $95.50 / $181.97