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Montana rates for HCPCS 64890

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,070.13 / $1,448.71 / $5,633.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,707.27 / $1,707.27 / $1,707.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$940.22 / $1,707.27 / $1,833.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$844.56 / $1,161.27 / $1,707.27
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,034.88 / $1,707.27 / $2,239.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,343.09 / $1,343.09 / $12,808.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,468.28 / $1,782.00 / $1,999.36