go back

Delaware 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
$97.72 / $186.21 / $1,288.25
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$758.58 / $758.58 / $758.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $208.93 / $467.74
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$338.84 / $467.74 / $645.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $524.81 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $190.55 / $346.74
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $3,019.95 / $3,630.78
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,890.45 / $3,890.45 / $3,890.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $436.52 / $5,011.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $169.82 / $380.19