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Montana rates for HCPCS 64454

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.04 / $210.15 / $431.52
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$116.09 / $116.09 / $630.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $141.69 / $350.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $128.82 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.30 / $128.82 / $315.16
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.83 / $128.82 / $211.44
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.75 / $218.04 / $426.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.55 / $350.90 / $387.20