go back

Utah rates for HCPCS 64901

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

Facilitymedian $3,715 · 10th–90th $891–$4,8980%10%20%10th90th$3,715Professionalmedian $871 · 10th–90th $525–$3,0900%10%20%10th90th$871$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $3,715.35 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $891.25 / $3,090.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $851.14 / $1,288.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,202.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,122.02 / $2,344.23
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $1,071.52 / $1,445.44
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $851.14 / $1,230.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $630.96 / $1,000.00