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Montana 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
$2,245.79 / $2,245.79 / $2,245.79
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$492.30 / $492.30 / $492.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.59 / $112.29 / $218.74
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$162.54 / $511.65 / $898.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.93 / $174.04 / $220.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.04 / $174.04 / $174.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.88 / $160.69 / $219.24
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.87 / $108.13 / $148.68
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.86 / $187.00 / $262.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.54 / $213.92 / $242.11