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Montana rates for HCPCS 64421

Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (List separately in addition to code for primary procedure)

Facilitymedian $58 · 10th–90th $42–$3240%20%10th90th$58Professionalmedian $74 · 10th–90th $28–$2750%10%10th90th$74$20.0$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
$26.92 / $79.43 / $275.42
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
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
$44.67 / $52.48 / $52.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $38.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $97.72 / $309.03
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $57.54 / $295.12
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $57.54 / $295.12
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $131.83 / $354.81
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $66.07 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $57.54 / $257.04