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Maryland rates for HCPCS 64681

Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $389.05 / $891.25
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $239.88 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $446.68 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $407.38 / $912.01
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $549.54 / $891.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.20 / $141.25 / $426.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $436.52 / $933.25
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $562.34 / $741.31