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Montana rates for HCPCS 64451

Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.51 / $197.62 / $315.64
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$298.08 / $298.08 / $298.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.77 / $127.77 / $359.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.77 / $127.77 / $127.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.28 / $127.77 / $323.69
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.58 / $127.77 / $217.26
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.69 / $224.19 / $438.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.49 / $347.42 / $383.36