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Illinois rates for HCPCS 64804

Sympathectomy, cervicothoracic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $3,090.30 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,318.26 / $2,754.23
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $3,388.44 / $27,542.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,621.81 / $2,344.23
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $2,089.30 / $4,265.80
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
$1,318.26 / $1,584.89 / $1,862.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $281.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $2,290.87 / $4,786.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,348.96 / $2,454.71