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Utah 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)

Facilitymedian $3,020 · 10th–90th $295–$4,5710%10%20%10th90th$3,020Professionalmedian $229 · 10th–90th $79–$5620%5%10%10th90th$229$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $3,162.28 / $5,888.44
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,513.56 / $1,513.56 / $2,951.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $229.09 / $602.56
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$218.78 / $295.12 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $186.21 / $371.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $524.81
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,348.96 / $2,089.30
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,479.11 / $2,041.74 / $3,090.30
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $257.04 / $467.74
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $251.19 / $398.11
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $323.59 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $2,818.38 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $173.78 / $309.03