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Montana 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 $166 · 10th–90th $87–$8710%20%10th90th$166Professionalmedian $110 · 10th–90th $49–$3980%10%10th90th$110$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$91.20 / $794.33 / $1,949.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $109.65 / $512.86
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$69.18 / $144.54 / $204.17
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $77,624.71 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $173.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $87.10 / $186.21
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $107.15 / $194.98
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $107.15 / $194.98
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $123.03 / $223.87
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $97.72 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $123.03 / $204.17