go back

Montana rates for HCPCS 64902

Nerve graft, each additional nerve; multiple strands (cable) (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$680.86 / $910.78 / $3,584.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,069.48 / $1,069.48 / $1,069.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$615.44 / $1,069.48 / $1,093.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$528.59 / $726.81 / $1,069.48
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$654.76 / $1,069.48 / $1,416.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$972.58 / $1,124.48 / $1,272.67