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Utah 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
$158.49 / $3,019.95 / $4,570.88
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$794.33 / $851.14 / $851.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $107.15 / $426.58
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$104.71 / $275.42 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $102.33 / $151.36
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $190.55
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $512.86 / $1,148.15
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$645.65 / $758.58 / $1,737.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $138.04 / $275.42
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $95.50 / $173.78
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $109.65 / $165.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $79.43 / $125.89