go back

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
$1,047.13 / $1,445.44 / $2,691.53
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46,773.51 / $81,283.05 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,479.11 / $1,819.70
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $1,862.09 / $2,238.72
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $1,862.09 / $2,238.72
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,548.82 / $2,290.87
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,479.11 / $2,238.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,778.28 / $2,041.74