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Idaho rates for HCPCS 64612

Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,407.00 / $4,500.00 / $7,045.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.36 / $175.20 / $335.35
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$217.52 / $342.47 / $1,179.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.14 / $95.14 / $95.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.41 / $192.56 / $230.71
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.38 / $261.77 / $359.93
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.14 / $228.21 / $291.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $188.93 / $213.31
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$506.67 / $724.18 / $906.75
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$744.20 / $1,086.27 / $1,399.43
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.95 / $244.08 / $282.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.00 / $1,800.00 / $9,193.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.16 / $225.38 / $309.33