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Wisconsin rates for HCPCS 64901

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

Facilitymedian $1,778 · 10th–90th $562$11,2200%5%10%10th90th$1,778Professionalmedian $832 · 10th–90th $525$2,4550%10%10th90th$832$50.0$200.0$1.0K$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
$524.81 / $1,174.90 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $588.84 / $1,479.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $8,709.64 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $1,096.48 / $2,754.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,698.24 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $2,238.72 / $2,570.40
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $1,148.15 / $4,168.69
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,348.96 / $1,737.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $954.99 / $1,778.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,096.48 / $4,265.80
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $933.25 / $2,344.23
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,412.54 / $2,454.71
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $1,230.27 / $1,819.70
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $3,630.78 / $3,630.78
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $2,818.38 / $4,168.69
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,311.31 / $3,715.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,659.59 / $3,467.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $912.01 / $2,454.71