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Wisconsin rates for HCPCS 64612

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

Facilitymedian $2,399 · 10th–90th $166$4,6770%10%10th90th$2,399Professionalmedian $251 · 10th–90th $117$8510%10%10th90th$251$10.0$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
$112.20 / $363.08 / $1,023.29
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$831.76 / $831.76 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $186.21 / $457.09
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$204.17 / $616.60 / $1,348.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $3,090.30 / $5,754.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $223.87 / $549.54
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$190.55 / $338.84 / $831.76
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $144.54 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $426.58 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $338.84 / $616.60
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $213.80 / $3,162.28
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $295.12 / $398.11
DeanCare
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$323.59 / $436.52 / $602.56
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $223.87 / $1,584.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $281.84 / $1,737.80
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $204.17
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $891.25 / $2,344.23
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $363.08 / $549.54
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $323.59 / $501.19
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $302.00 / $1,288.25
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $660.69 / $1,737.80
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $467.74
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $691.83 / $812.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,584.89 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $204.17 / $501.19
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$79.43 / $79.43 / $218.78