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Oklahoma rates for HCPCS 64804

Sympathectomy Cervicothoracic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,049.16 / $3,742.00 / $18,600.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$955.05 / $1,060.44 / $1,060.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.00 / $900.00 / $900.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.40 / $1,389.61 / $1,845.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$898.54 / $1,351.33 / $4,177.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$924.62 / $1,232.82 / $9,520.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.00 / $2,072.00 / $4,083.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$864.01 / $1,085.76 / $1,664.31