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Myelogram Of The Lower Back, Injection And X-ray Imaging

Arizona rates for HCPCS 62304

A dye study of the lower back and tailbone portion of the spine. Contrast dye is injected through a needle into the fluid-filled space around the spinal cord and nerve roots, and x-ray images are then taken and interpreted. The injection and the imaging are both part of this service.

Rates data updated July 2026.

Facilitymedian $2,089 · 10th–90th $182$5,6230%5%10%10th90th$2,089Professionalmedian $214 · 10th–90th $105$4270%10%10th90th$214$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
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$3,090.30
Typical High
$6,309.57
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$208.93
Typical High
$371.54
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$478.63
Typical High
$912.01
BCBS
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$173.78
Typical High
$354.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$251.19
Typical High
$457.09
Medica
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$239.88
Typical High
$1,230.27
Medica
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$346.74
Typical High
$1,862.09
United
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$1,258.93
Typical High
$3,235.94
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$239.88
Typical High
$549.54