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Utah rates for HCPCS 64896

Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $5,888.44 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,778.28 / $7,585.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $2,041.74 / $3,311.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $2,818.38
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
$2,187.76 / $2,754.23 / $6,309.57
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $2,630.27 / $3,467.37
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,238.72 / $3,467.37
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
$1,230.27 / $1,513.56 / $2,398.83