go back

Wisconsin rates for HCPCS 64901

Nerve Graft Each Nerve 1 Strand

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$527.01 / $1,169.06 / $14,482.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$527.01 / $574.17 / $2,208.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,159.00 / $8,456.00 / $10,914.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$570.10 / $1,281.45 / $3,269.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,462.52 / $1,709.07 / $2,621.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$896.29 / $2,197.03 / $2,496.63
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$519.58 / $697.13 / $1,169.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$527.01 / $806.33 / $1,778.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$668.01 / $1,153.52 / $4,282.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.90 / $600.48 / $1,321.18
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$519.58 / $665.06 / $1,169.06
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,149.79 / $1,401.84 / $2,092.67
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,679.44 / $2,679.44 / $2,679.44
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,103.78 / $2,833.55 / $4,282.72
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.16 / $1,995.16 / $1,995.16
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,794.83 / $3,289.85 / $3,289.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,034.00 / $1,423.00 / $2,202.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$625.07 / $1,085.76 / $2,512.83