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

Utah 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 $2,951 · 10th–90th $339$4,5710%10%10th90th$2,951Professionalmedian $263 · 10th–90th $95$6310%5%10%10th90th$263$50.0$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
$181.97
Median
$3,019.95
Typical High
$4,570.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$263.03
Typical High
$630.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$281.84
Typical High
$457.09
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$295.12
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$1,548.82
Typical High
$2,344.23
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$346.74
Typical High
$501.19
Select Health
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$371.54
Typical High
$371.54
Select Health
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$162.18
Typical High
$218.78
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$363.08
Typical High
$478.63
United
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$2,818.38
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$223.87
Typical High
$416.87