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Pennsylvania rates for HCPCS 64681

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

Facilitymedian $3,802 · 10th–90th $871–$8,3180%10%10th90th$3,802Professionalmedian $398 · 10th–90th $200–$8130%20%10th90th$398$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$954.99 / $3,890.45 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $389.05 / $794.33
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,466.84 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $457.09 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $389.05 / $812.83
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $758.58 / $954.99
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $562.34 / $758.58
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $2,570.40 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $398.11 / $812.83
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $741.31 / $977.24
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $295.12 / $457.09
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $436.52 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $1,905.46 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $436.52 / $831.76