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Nebraska rates for HCPCS 64624

Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$362.48 / $3,908.01 / $13,841.56
Aetna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$1,011.00 / $1,011.00 / $1,011.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.69 / $362.48 / $1,203.20
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$203.55 / $203.55 / $203.55
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,973.60 / $6,541.64 / $12,653.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.06 / $327.43 / $736.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,387.40 / $1,387.40 / $1,387.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.58 / $558.00 / $1,121.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$156.06 / $408.86 / $1,020.74
Medica
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$534.08 / $534.08 / $1,213.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.99 / $834.05 / $1,095.68
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$345.40 / $901.86 / $1,750.65
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.95 / $725.72 / $1,189.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,217.00 / $6,451.00 / $7,934.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$459.32 / $821.95 / $1,008.51