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Maryland rates for HCPCS 64517

Injection Anes Superior Hypogastric Plexus

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.76 / $178.06 / $350.80
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.58 / $134.90 / $148.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$445.00 / $445.00 / $451.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.53 / $202.45 / $388.32
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.55 / $257.50 / $390.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.00 / $123.00 / $158.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.05 / $209.53 / $392.60
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.22 / $229.55 / $285.08