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Maryland rates for HCPCS 64857

Sutr Prph Nrv Arm/Leg Xcp Sciatic W/O Trpos

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,398.95 / $4,398.95 / $4,398.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$967.34 / $1,079.85 / $2,773.21
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,021.43 / $1,134.92 / $1,248.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$445.00 / $453.73 / $2,916.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$949.90 / $1,392.68 / $2,308.48
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,095.77 / $1,421.05 / $1,845.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.00 / $847.00 / $1,560.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$823.38 / $1,168.30 / $2,141.82
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$992.66 / $1,266.83 / $1,556.52