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Maine 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 $1,585 · 10th–90th $347–$2,7540%20%10th90th$1,585Professionalmedian $214 · 10th–90th $112–$4170%5%10%10th90th$214$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$1,202.26 / $2,398.83 / $2,754.23
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$346.74 / $1,380.38 / $2,630.27
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $208.93 / $371.54
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$173.78 / $281.84 / $588.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $158.49 / $223.87
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$141.25 / $234.42 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $239.88 / $398.11
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $251.19 / $407.38
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $194.98 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $194.98 / $398.11