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Nebraska 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
$676.08 / $2,187.76 / $8,511.38
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,949.84 / $2,754.23 / $3,801.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $239.88 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$263.03 / $588.84 / $1,737.80
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $151.36 / $234.42
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$134.90 / $251.19 / $537.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,949.84 / $3,801.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $199.53 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $724.44 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $331.13 / $575.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $281.84 / $1,479.11
Medica
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,949.84 / $1,949.84 / $1,949.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $389.05 / $1,023.29
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $363.08 / $549.54
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $724.44 / $724.44
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $323.59 / $588.84
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,025.60 / $6,025.60 / $7,079.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,819.70 / $6,309.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $245.47 / $467.74