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Nebraska 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
Facility
Modifier
Low / Median / High Price
$1,653.00 / $5,463.36 / $13,841.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$528.00 / $528.00 / $3,094.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,810.78 / $8,958.04 / $17,327.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$507.35 / $864.79 / $1,153.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,057.23 / $1,275.39 / $1,762.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$528.00 / $976.80 / $1,724.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$722.89 / $1,179.55 / $1,622.46
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$857.53 / $1,288.19 / $1,762.81
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$967.00 / $1,252.47 / $1,762.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,031.00 / $1,775.00 / $4,406.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$722.89 / $1,269.31 / $1,466.91