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Alaska rates for HCPCS 64804

Sympathectomy Cervicothoracic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,300.99 / $10,900.00 / $14,552.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,095.24 / $5,453.17 / $5,453.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,810.36 / $3,752.87 / $5,068.77
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,095.24 / $5,453.17 / $7,634.44
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,966.98 / $3,560.37 / $7,227.93
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,757.60 / $5,320.05 / $6,920.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,137.30 / $5,453.17 / $7,634.44
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,713.06 / $5,124.00 / $7,906.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,002.30 / $4,529.28 / $6,830.23