go back

Maryland rates for HCPCS 64612

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

Facilitymedian $110 · 10th–90th $71–$3310%10%10th90th$110Professionalmedian $200 · 10th–90th $115–$5620%5%10%10th90th$200$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $134.90 / $229.09
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$109.65 / $109.65 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $165.96 / $407.38
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$218.78 / $416.87 / $954.99
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $134.90 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $173.78 / $302.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $169.82 / $275.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $40.74 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $158.49 / $269.15
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $173.78 / $218.78