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South Dakota rates for HCPCS 64612

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

Facilitymedian $200 · 10th–90th $115–$2,2910%10%10th90th$200Professionalmedian $219 · 10th–90th $115–$3890%5%10%10th90th$219$100.0$200.0$500.0$1.0K$2.0K

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
$114.82 / $134.90 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $154.88 / $295.12
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$218.78 / $407.38 / $446.68
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $134.90 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $316.23 / $398.11
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $223.87 / $316.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $275.42 / $1,737.80
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $302.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $257.04 / $288.40
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $223.87 / $269.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $218.78 / $354.81
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $281.84 / $323.59