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New Hampshire rates for HCPCS 64612

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

Facilitymedian $1,549 · 10th–90th $490$9,7720%10%20%10th90th$1,549Professionalmedian $214 · 10th–90th $132$4370%5%10%10th90th$214$50.0$200.0$1.0K$5.0K

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
$489.78 / $1,819.70 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $158.49 / $407.38
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$218.78 / $426.58 / $741.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,412.54 / $3,467.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $194.98 / $281.84
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$162.18 / $295.12 / $416.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $229.09 / $363.08
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $371.54
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $165.96
Well Sense
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78