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Massachusetts rates for HCPCS 64804

Sympathectomy Cervicothoracic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$941.37 / $2,747.00 / $5,454.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$815.65 / $1,086.41 / $1,785.10
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$941.10 / $3,592.00 / $8,498.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,020.68 / $1,958.24 / $9,520.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,164.52 / $1,851.25 / $3,245.42
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,180.48 / $1,915.08 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,354.60 / $1,627.82 / $2,247.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,502.82 / $2,966.57 / $3,830.69
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $3,372.00 / $12,537.14
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,118.63 / $2,006.79 / $9,520.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,640.00 / $3,592.00 / $8,425.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,082.04 / $1,616.77 / $3,585.68