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Maryland rates for HCPCS 64901

Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$544.82 / $594.65 / $1,554.42
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.18 / $663.18 / $1,010.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$445.00 / $445.00 / $453.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$543.22 / $805.78 / $1,514.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$606.32 / $791.74 / $1,059.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.00 / $36.00 / $41.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$477.22 / $649.04 / $1,141.45
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$580.01 / $705.81 / $866.18