go back

Utah rates for HCPCS 64615

Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$183.80 / $444.59 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.54 / $231.87 / $642.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.38 / $195.71 / $285.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.60 / $127.47 / $164.82
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.21 / $561.58 / $818.38
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.80 / $285.36 / $404.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,078.00 / $1,556.00 / $4,495.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.63 / $160.74 / $257.92