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South Dakota 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 $794 · 10th–90th $50–$2,2910%10%20%10th90th$794Professionalmedian $123 · 10th–90th $50–$5750%10%10th90th$123$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$48.98 / $870.96 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $114.82 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $57.54 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $144.54 / $323.59
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $134.90 / $263.03
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $190.55 / $2,511.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $123.03 / $223.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $117.49 / $213.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $138.04 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $128.82 / $251.19
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $117.49 / $257.04