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Virginia 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
$679.69 / $3,645.00 / $8,294.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$541.91 / $652.32 / $803.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.27 / $690.89 / $1,142.24
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.18 / $676.00 / $1,253.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$572.00 / $572.00 / $669.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.16 / $780.48 / $1,303.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.76 / $708.81 / $827.18
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$559.79 / $777.24 / $1,125.47
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.00 / $866.00 / $1,170.45
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$580.51 / $803.85 / $1,371.95
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$580.51 / $803.85 / $1,371.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$231.00 / $1,045.00 / $2,364.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.09 / $731.33 / $1,136.30