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Utah rates for HCPCS 64891

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $3,715.35 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,445.44 / $6,165.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,584.89 / $2,691.53
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $2,511.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,332.54 / $11,220.18 / $26,302.68
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,238.72 / $3,890.45
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $2,089.30 / $2,818.38
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,819.70 / $2,754.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,202.26 / $1,905.46