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Maine 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
$20,892.96 / $20,892.96 / $20,892.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,258.93 / $3,019.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,659.59 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,621.81 / $2,398.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,445.44 / $2,754.23
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,892.96 / $20,892.96 / $20,892.96
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,479.11 / $3,235.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,412.54 / $2,344.23