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Utah rates for HCPCS 64415

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

Facilitymedian $2,630 · 10th–90th $537–$4,0740%10%10th90th$2,630Professionalmedian $138 · 10th–90th $65–$3980%5%10%10th90th$138$20.0$100.0$500.0$2.0K

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
$537.03 / $2,754.23 / $4,073.80
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,000.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $138.04 / $398.11
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$537.03 / $537.03 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $112.20 / $190.55
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $100.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,737.80 / $2,691.53
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,905.46 / $2,630.27 / $3,981.07
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $194.98 / $316.23
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $194.98 / $354.81
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $186.21 / $288.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $2,818.38 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $107.15 / $181.97