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Idaho rates for HCPCS 64415

Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$187.27 / $330.68 / $6,159.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.43 / $117.71 / $277.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$573.77 / $573.77 / $575.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.45 / $127.85 / $202.42
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.56 / $164.76 / $305.68
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.01 / $212.95 / $262.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $185.64 / $233.55
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,036.93 / $2,281.73 / $2,842.02
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,448.18 / $3,422.61 / $4,306.64
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.88 / $166.75 / $277.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.00 / $2,620.00 / $4,441.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.68 / $173.88 / $262.50