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Wisconsin rates for HCPCS 64417

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $776.25 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $138.04 / $389.05
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$208.93 / $208.93 / $208.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $3,090.30 / $5,754.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $144.54 / $346.74
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$138.04 / $213.80 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $501.19 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $275.42 / $724.44
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $158.49 / $3,162.28
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $234.42 / $426.58
DeanCare
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$177.83 / $354.81 / $645.65
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $162.18 / $3,311.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $251.19 / $1,230.27
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $95.50
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $275.42 / $602.56
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,691.53 / $2,691.53
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $660.69 / $1,230.27
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $398.11 / $954.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $2,818.38 / $4,677.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $173.78 / $467.74