go back

Michigan 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)

Facilitymedian $603 · 10th–90th $69$2,0420%10%10th90th$603Professionalmedian $112 · 10th–90th $49$3630%10%10th90th$112$0.5$2.0$10.0$50.0$200.0$1.0K$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
$67.61 / $602.56 / $2,041.74
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$128.82 / $741.31 / $1,023.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $109.65 / $371.54
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$75.86 / $144.54 / $457.09
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $47.86 / $181.97
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $151.36 / $173.78
BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$162.18 / $218.78 / $346.74
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $74.13 / $104.71
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $138.04 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $85.11 / $173.78
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $549.54 / $2,041.74
Health Alliance Plan
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$128.82 / $741.31 / $1,023.29
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $114.82 / $263.03
Health Alliance Plan
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$75.86 / $144.54 / $331.13
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $83.18 / $158.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $1,202.26 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $91.20 / $162.18