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Montana rates for HCPCS 64415

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

Facilitymedian $174 · 10th–90th $112–$2570%20%10th90th$174Professionalmedian $123 · 10th–90th $63–$3800%20%10th90th$123$100.0$500.0$2.0K$10.0K$50.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $123.03 / $363.08
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $107.15 / $194.98
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $194.98 / $239.88
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $194.98 / $239.88
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $141.25 / $239.88
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $138.04 / $213.80