go back

South Dakota 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
Facility
Modifier
Low / Median / High Price
$80.09 / $226.57 / $226.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.90 / $117.87 / $226.57
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$116.09 / $116.09 / $116.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.21 / $279.33 / $638.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.68 / $272.23 / $382.90
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.77 / $459.82 / $1,886.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.78 / $475.99 / $873.61
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.34 / $384.08 / $558.46
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.13 / $261.69 / $423.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,643.00 / $1,643.00 / $1,643.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.26 / $427.74 / $601.78
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.50 / $193.90 / $513.50