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Maine 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
$316.23 / $575.44 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $109.65 / $239.88
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$75.86 / $144.54 / $371.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $75.86 / $120.23
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$66.07 / $114.82 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $120.23 / $239.88
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $141.25 / $234.42
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $575.44 / $2,454.71
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $112.20 / $251.19
Martin's Point
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$75.86 / $144.54 / $371.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $95.50 / $190.55