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Indiana rates for HCPCS 64616

Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.41 / $250.34 / $5,634.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,206.16 / $2,206.16 / $2,206.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.80 / $115.46 / $184.52
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$168.66 / $299.58 / $426.00
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$254.18 / $254.18 / $254.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$856.00 / $4,320.00 / $8,230.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.16 / $94.31 / $130.13
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$120.24 / $141.46 / $195.22
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.82 / $129.36 / $194.04
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.47 / $151.84 / $191.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.77 / $92.77 / $109.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.59 / $150.79 / $211.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.00 / $2,252.00 / $4,426.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.67 / $144.97 / $246.62