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Utah rates for HCPCS 64400

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

Facilitymedian $676 · 10th–90th $407–$4,4670%20%10th90th$676Professionalmedian $145 · 10th–90th $54–$6310%5%10th90th$145$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$363.08 / $549.54 / $4,466.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $128.82 / $562.34
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$144.54 / $275.42 / $933.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $112.20 / $190.55
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $83.18
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $575.44 / $891.25
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$630.96 / $870.96 / $1,318.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $177.83 / $323.59
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $125.89 / $234.42
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $154.88 / $239.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $97.72 / $165.96