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

Pennsylvania 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 $1,585 · 10th–90th $209$7,2440%5%10th90th$1,585Professionalmedian $219 · 10th–90th $107$3800%10%10th90th$219$100.0$500.0$2.0K$10.0K$50.0K

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
$208.93
Median
$1,584.89
Typical High
$7,244.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$213.80
Typical High
$371.54
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$2,691.53
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$251.19
Typical High
$436.52
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$234.42
Typical High
$446.68
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$346.74
Typical High
$426.58
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$257.04
Typical High
$457.09
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$1,584.89
Typical High
$2,511.89
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$134.90
Typical High
$151.36
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$1,513.56
Typical High
$6,165.95
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$229.09
Typical High
$660.69
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$234.42
Typical High
$501.19
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$1,023.29
Typical High
$1,778.28
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$138.04
Typical High
$269.15
United
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$1,584.89
Typical High
$3,890.45
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$251.19
Typical High
$467.74