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

Michigan 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 $1,698 · 10th–90th $195$3,8900%10%20%10th90th$1,698Professionalmedian $214 · 10th–90th $110$4070%10%10th90th$214$20.0$100.0$500.0$2.0K$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
$194.98
Median
$1,698.24
Typical High
$3,890.45
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$218.78
Typical High
$380.19
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
BCBS
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$154.88
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$251.19
Typical High
$549.54
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$616.60
Typical High
$4,897.79
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$251.19
Typical High
$407.38
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$281.84
Typical High
$478.63
United
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$1,584.89
Typical High
$4,073.80
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$263.03
Typical High
$575.44