go back

Montana rates for HCPCS 64630

Destruction by neurolytic agent; pudendal nerve

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.68 / $349.77 / $1,283.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$301.81 / $301.81 / $301.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.42 / $278.93 / $387.61
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.32 / $212.71 / $336.02
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.24 / $323.58 / $490.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.08 / $381.70 / $439.85