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Wisconsin 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 $912 · 10th–90th $1–$2,5700%10%10th90th$912Professionalmedian $145 · 10th–90th $51–$5500%10%10th90th$145$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$0.95 / $912.01 / $2,137.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $128.82 / $575.44
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$75.86 / $151.36 / $436.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,584.89 / $6,165.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $117.49 / $251.19
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$112.20 / $173.78 / $371.54
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $60.26 / $81.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $346.74 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $204.17 / $512.86
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $120.23 / $3,162.28
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $173.78 / $295.12
DeanCare
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$141.25 / $257.04 / $446.68
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $128.82 / $1,513.56
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $239.88 / $2,511.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $112.20
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $891.25 / $2,344.23
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $204.17 / $338.84
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $181.97 / $389.05
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $1,995.26 / $1,995.26
Quartz
Facility/Professional
Facility
Modifier
53
Typical Low / Median / Typical High
$26.30 / $26.30 / $295.12
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $562.34 / $2,511.89
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $407.38
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $316.23 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,659.59 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $134.90 / $363.08