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Montana rates for HCPCS 64893

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,513.56 / $2,951.21
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
$1,778.28 / $1,778.28 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,548.82 / $1,905.46
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $1,949.84 / $2,344.23
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $1,949.84 / $2,344.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,621.81 / $2,344.23
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,548.82 / $2,290.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,862.09 / $2,137.96