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Pennsylvania 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.36 / $1,340.00 / $6,012.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$5,470.37 / $5,470.37 / $5,470.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.99 / $55.85 / $210.02
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$125.21 / $125.21 / $125.21
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.15 / $35.15 / $35.15
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.69 / $3,159.00 / $14,886.03
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.03 / $52.54 / $274.70
Capital Blue Cross
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$49.54 / $78.81 / $412.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.84 / $41.84 / $41.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.74 / $56.98 / $289.05
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.52 / $50.84 / $66.54
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$810.94 / $1,605.95 / $2,408.77
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,158.02 / $2,158.02 / $2,158.02
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.60 / $295.60 / $295.60
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.83 / $1,544.00 / $7,175.00
Martin's Point
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$5,470.37 / $5,470.37 / $5,470.37
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.65 / $73.20 / $249.91
Martin's Point
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$125.21 / $125.21 / $125.21
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.40 / $51.28 / $204.50
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.84 / $41.84 / $41.84
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.72 / $54.60 / $304.29
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.86 / $32.08 / $371.18
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.86 / $31.36 / $180.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$435.00 / $1,219.00 / $3,742.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.97 / $53.83 / $318.62