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

Indiana 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 $3,631 · 10th–90th $166$7,4130%5%10th90th$3,631Professionalmedian $191 · 10th–90th $105$3160%10%10th90th$191$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$131.83
Median
$426.58
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$199.53
Typical High
$302.00
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$120.23
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$4,365.16
Typical High
$8,709.64
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$123.03
Typical High
$218.78
CareSource
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$117.49
Typical High
$131.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$186.21
Typical High
$489.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$223.87
Typical High
$436.52
United
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$2,754.23
Typical High
$4,265.80
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$234.42
Typical High
$436.52