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Idaho rates for HCPCS 64645

Chemodenervation of one extremity; each additional extremity, 5 or more muscles (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,407.00 / $4,500.00 / $7,045.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.05 / $122.30 / $290.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.88 / $143.46 / $200.71
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.13 / $154.24 / $319.31
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.22 / $193.74 / $234.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $164.27 / $206.66
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.44 / $186.35 / $248.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.00 / $1,800.00 / $9,193.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.48 / $170.85 / $244.59