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Alaska rates for HCPCS 64490

Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level

Facilitymedian $2,818 · 10th–90th $263–$6,6070%10%10th90th$2,818Professionalmedian $224 · 10th–90th $102–$5890%10%10th90th$224$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
$1,819.70 / $2,818.38 / $9,772.37
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$3,019.95 / $3,090.30 / $3,235.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $194.98 / $371.54
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$208.93 / $398.11 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $269.15 / $602.56
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $549.54 / $3,890.45
Moda Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,862.09 / $3,090.30 / $3,235.94
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $457.09 / $954.99
Moda Health
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$208.93 / $380.19 / $588.84
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $691.83 / $1,023.29
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $295.12 / $870.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $213.80 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $389.05 / $954.99