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Indiana rates for HCPCS 64804

Sympathectomy Cervicothoracic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,068.36 / $1,386.00 / $4,846.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$955.05 / $1,082.04 / $1,335.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,153.00 / $5,790.87 / $8,240.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.77 / $1,280.80 / $1,767.50
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,062.76 / $1,458.69 / $2,188.04
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,041.92 / $1,302.40 / $1,875.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,016.02 / $1,331.54 / $2,107.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,400.00 / $3,874.00 / $5,490.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$845.55 / $1,195.83 / $2,065.75