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Ohio rates for HCPCS 64804

Sympathectomy, cervicothoracic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,086.41 / $4,723.00 / $11,627.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$955.05 / $1,097.09 / $1,877.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,121.00 / $2,786.00 / $8,800.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.54 / $1,150.05 / $1,841.99
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,077.84 / $1,383.34 / $1,837.25
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,268.06 / $1,613.89 / $127,498.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,030.99 / $1,498.61 / $2,204.14
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,366.34 / $1,366.34 / $1,366.34
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,089.04 / $1,539.21 / $2,204.14
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.81 / $1,046.15 / $1,583.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,689.00 / $2,665.00 / $4,951.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$856.45 / $1,378.67 / $2,205.03