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Utah rates for HCPCS 64620

Destruction by neurolytic agent, intercostal nerve

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $251.19 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $257.04 / $446.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $331.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $1,584.89 / $3,630.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $380.19 / $562.34
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $323.59 / $446.68
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $309.03 / $416.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $2,818.38 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $208.93 / $323.59