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New Hampshire 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 $851 · 10th–90th $95–$8,9130%5%10%10th90th$851Professionalmedian $112 · 10th–90th $52–$2750%5%10%10th90th$112$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
$95.50 / $851.14 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $109.65 / $295.12
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$144.54 / $144.54 / $371.54
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $61.66 / $69.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $100.00 / $138.04
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$66.07 / $147.91 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $141.25 / $281.84
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $131.83 / $263.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $128.82 / $275.42
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $114.82 / $138.04
Well Sense
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25