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South Dakota rates for HCPCS 64400

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

Facilitymedian $617 · 10th–90th $112–$1,1220%10%20%10th90th$617Professionalmedian $112 · 10th–90th $50–$2510%10%20%10th90th$112$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$112.20 / $616.60 / $1,288.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $109.65 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $186.21 / $323.59
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $162.18 / $275.42
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $269.15 / $1,023.29
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $302.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $154.88 / $281.84
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $154.88 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $134.90 / $295.12
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $123.03 / $263.03