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New Hampshire rates for HCPCS 64643

Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (List separately in addition to code for primary procedure)

Facilitymedian $479 · 10th–90th $107–$8,9130%10%20%10th90th$479Professionalmedian $117 · 10th–90th $74–$2240%10%10th90th$117$50.0$200.0$1.0K$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
$107.15 / $478.63 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $107.15 / $223.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $123.03 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $138.04 / $245.47
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $125.89 / $223.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $229.09
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $48.98 / $112.20