go back

Utah rates for HCPCS 64505

Injection Anes Agent Sphenopalatine Ganglion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.02 / $2,910.00 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.00 / $137.93 / $504.47
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$517.23 / $517.23 / $517.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.03 / $140.80 / $262.62
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.54 / $118.80 / $148.82
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.21 / $561.58 / $818.38
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$648.32 / $842.37 / $1,227.57
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.46 / $235.23 / $278.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,078.00 / $1,556.00 / $4,495.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.36 / $131.12 / $199.09