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Washington, DC 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.53 / $1,862.09 / $4,073.80
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$933.25 / $933.25 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $257.04 / $2,238.72
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$154.88 / $588.84 / $5,754.40
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $257.04 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $229.09 / $457.09
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $234.42 / $446.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $1,737.80 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $208.93 / $478.63