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Iowa rates for HCPCS 64804

Sympathectomy Cervicothoracic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,277.00 / $6,066.00 / $11,100.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$743.47 / $1,474.21 / $1,622.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,604.00 / $2,529.73 / $3,162.17
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,111.73 / $1,606.87 / $3,030.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,542.51 / $2,434.66 / $5,023.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,116.96 / $2,058.32 / $9,520.27
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,604.00 / $2,315.19 / $3,317.01
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,346.51 / $2,264.78 / $3,246.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,559.00 / $4,645.00 / $6,267.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,069.58 / $1,711.34 / $3,208.77
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,860.13 / $2,354.60 / $2,770.10