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Montana rates for HCPCS 64901

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

Facilitymedian $1,023 · 10th–90th $759–$1,0960%50%10th90th$1,023Professionalmedian $891 · 10th–90th $562–$1,4450%10%20%10th90th$891$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $794.33 / $1,621.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $933.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $776.25 / $933.25
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,023.29 / $1,071.52
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,023.29 / $1,071.52
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $912.01 / $1,348.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $794.33 / $1,202.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $977.24 / $1,148.15