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Utah rates for HCPCS 64640

Dstrj Neurolytic Agent Other Peripheral Nerve

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.51 / $2,552.39 / $4,387.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,169.33 / $1,169.33 / $1,405.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.29 / $240.25 / $622.75
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$86.22 / $355.28 / $1,212.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.59 / $221.62 / $416.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.98 / $169.75 / $228.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,361.81 / $1,728.22 / $2,518.51
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,042.72 / $2,592.33 / $3,777.77
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.05 / $278.79 / $458.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,106.00 / $1,649.00 / $2,824.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.24 / $241.71 / $387.75