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Utah 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 $3,020 · 10th–90th $275–$4,5710%20%10th90th$3,020Professionalmedian $95 · 10th–90th $29–$3310%5%10th90th$95$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
$275.42 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $97.72 / $338.84
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$109.65 / $109.65 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $79.43 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $281.84
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
$38.90 / $56.23 / $371.54
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $51.29 / $512.86
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $48.98 / $77.62
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
$25.12 / $72.44 / $239.88