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Utah rates for HCPCS 64630

Destruction by neurolytic agent; pudendal nerve

Facilitymedian $3,388 · 10th–90th $316–$4,7860%10%10th90th$3,388Professionalmedian $302 · 10th–90th $186–$1,1480%10%10th90th$302$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $3,715.35 / $4,786.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $295.12 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $281.84 / $436.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $371.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,737.80 / $2,691.53
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $436.52 / $602.56
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $363.08 / $501.19
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $363.08 / $512.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $2,818.38 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $229.09 / $354.81