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

Hawaii 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 $2,884 · 10th–90th $1,000$2,8840%50%10th$2,884Professionalmedian $204 · 10th–90th $105$3390%10%10th90th$204$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$1,000.00
Median
$2,884.03
Typical High
$2,884.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$204.17
Typical High
$281.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$223.87
Typical High
$416.87
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$263.03
Typical High
$331.13
United
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$1,148.15
Typical High
$1,148.15
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$316.23
Typical High
$1,000.00
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$154.88
Typical High
$371.54