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Indiana rates for HCPCS 64484

Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $1,000.00 / $2,951.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $104.71 / $575.44
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$75.86 / $151.36 / $489.78
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $64.57 / $123.03
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$60.26 / $154.88 / $229.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $977.24 / $3,388.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $64.57 / $120.23
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$63.10 / $97.72 / $177.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $57.54 / $67.61
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $128.82 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $147.91 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $107.15 / $204.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $2,238.72 / $7,413.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $89.13 / $190.55