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Idaho rates for HCPCS 64890

Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,348.96 / $2,570.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $6,456.54 / $17,378.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,089.30 / $2,137.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $4,677.35 / $4,677.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,479.11 / $1,862.09
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,737.80 / $3,235.94
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,819.70 / $2,454.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,964.78 / $15,135.61 / $21,379.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $2,089.30 / $2,570.40
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,230.27 / $10,964.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $10,232.93 / $27,542.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,621.81 / $2,187.76