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Wisconsin rates for HCPCS 64454

Injection Aa&/Strd Genicular Nrv Branches W/Img

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.92 / $208.42 / $1,894.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.92 / $208.42 / $431.52
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$630.38 / $630.38 / $630.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,139.00 / $2,479.00 / $4,441.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.27 / $206.66 / $484.36
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$180.10 / $309.99 / $726.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.85 / $704.48 / $1,080.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.69 / $363.73 / $994.68
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.92 / $190.47 / $375.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.01 / $241.84 / $3,326.00
Medica
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,329.10 / $3,329.10 / $3,329.10
Medica
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$447.49 / $447.49 / $893.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.28 / $429.75 / $1,594.08
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.62 / $222.38 / $551.40
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.92 / $190.47 / $336.87
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.29 / $344.03 / $707.50
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$373.93 / $373.93 / $763.85
Quartz
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$299.14 / $299.14 / $299.14
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.96 / $616.79 / $1,886.00
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.85 / $479.23 / $1,310.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,957.00 / $3,068.00 / $4,295.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.26 / $421.48 / $973.32