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South Dakota rates for HCPCS 64405

Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.86 / $72.44 / $4,365.16
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$501.19 / $501.19 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $93.33 / $223.87
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$74.13 / $239.88 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $144.54 / $213.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $120.23 / $218.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $128.82 / $1,148.15
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $120.23 / $186.21
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $138.04 / $223.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $117.49 / $169.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $125.89 / $213.80
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $125.89 / $177.83