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Pennsylvania rates for HCPCS 64640

Dstrj Neurolytic Agent Other Peripheral Nerve

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$434.84 / $2,546.88 / $7,842.74
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$325.00 / $11,343.59 / $22,931.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.73 / $207.71 / $440.51
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$198.28 / $584.11 / $834.88
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.02 / $417.02 / $417.02
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.69 / $3,159.00 / $14,886.03
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.47 / $250.86 / $386.17
Capital Blue Cross
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$314.13 / $376.28 / $579.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$203.89 / $203.89 / $203.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.97 / $228.05 / $398.99
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.17 / $386.38 / $501.20
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$563.69 / $1,762.98 / $4,498.38
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,146.28 / $5,190.12 / $8,272.56
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.47 / $154.94 / $307.19
Highmark BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$216.92 / $413.25 / $441.60
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$594.00 / $2,578.00 / $7,842.74
Martin's Point
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$325.00 / $11,343.59 / $22,931.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.41 / $222.45 / $717.35
Martin's Point
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$198.28 / $545.89 / $834.88
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.40 / $334.70 / $527.20
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$203.89 / $203.89 / $203.89
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.97 / $228.05 / $412.97
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.98 / $237.34 / $327.68
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.98 / $233.78 / $255.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$435.00 / $1,219.00 / $3,742.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$219.23 / $304.02 / $474.92