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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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $91.20 / $331.13
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$109.65 / $109.65 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $79.43 / $257.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $281.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $1,584.89 / $3,630.78
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,041.74 / $2,398.83 / $5,370.32
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $66.07 / $407.38
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $51.29 / $512.86
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $48.98 / $91.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $2,818.38 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $60.26 / $229.09