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North Dakota 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
$107.15 / $1,348.96 / $3,467.37
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,318.26 / $3,801.89 / $4,466.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $194.98 / $489.78
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$173.78 / $691.83 / $1,096.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $288.40 / $457.09
BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$302.00 / $436.52 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $288.40 / $524.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.15 / $190.55 / $1,348.96
Medica
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,089.30 / $2,089.30 / $3,235.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $354.81 / $1,023.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $1,819.70 / $2,041.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $229.09 / $416.87