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Tennessee rates for HCPCS 64804

Sympathectomy, cervicothoracic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,821.00 / $2,683.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$941.37 / $1,157.95 / $1,633.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,565.00 / $2,800.00 / $3,834.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$910.63 / $1,285.59 / $2,066.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,066.15 / $1,420.44 / $2,285.23
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $14,897.74 / $15,240.94
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,520.27 / $9,520.27 / $10,766.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,130.00 / $2,297.00 / $4,099.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.65 / $1,224.96 / $2,280.30