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Montana rates for HCPCS 64681

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

Facilitymedian $562 · 10th–90th $331–$1,0000%20%10th90th$562Professionalmedian $468 · 10th–90th $214–$1,1480%10%10th90th$468$100.0$500.0$2.0K$10.0K$50.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $457.09 / $1,174.90
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $389.05 / $676.08
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $630.96 / $891.25
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $630.96 / $891.25
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $501.19 / $812.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $426.58 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $501.19 / $977.24