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Illinois rates for HCPCS 64804

Sympathectomy Cervicothoracic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,017.00 / $2,304.01 / $5,430.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$941.37 / $1,223.94 / $2,304.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,687.00 / $13,676.70 / $29,830.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.00 / $875.00 / $908.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$985.68 / $1,745.12 / $2,367.84
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,226.85 / $2,061.69 / $4,275.95
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,333.10 / $1,594.92 / $1,841.24
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $2,082.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,095.00 / $2,664.00 / $5,124.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$973.50 / $1,408.38 / $2,778.78