go back

New Hampshire rates for HCPCS 64681

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $781.42 / $6,067.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.07 / $390.88 / $640.85
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,223.09 / $1,359.00 / $3,300.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.16 / $372.10 / $571.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.62 / $1,751.69 / $1,812.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.17 / $599.20 / $1,139.32
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$268.81 / $554.60 / $1,245.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,035.00 / $8,035.00 / $8,035.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$583.05 / $782.73 / $1,339.99
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $285.83 / $544.80