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New Hampshire 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 $1,820 · 10th–90th $162$8,9130%10%10th90th$1,820Professionalmedian $224 · 10th–90th $117$4790%10%10th90th$224$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$162.18 / $1,819.70 / $9,772.37
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $218.78 / $467.74
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$281.84 / $338.84 / $1,148.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $208.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,412.54 / $3,467.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $208.93 / $288.40
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$141.25 / $309.03 / $436.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $257.04 / $501.19
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $7,943.28 / $7,943.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $234.42 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $7,943.28 / $7,943.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $245.47 / $512.86
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $54.95 / $234.42
Well Sense
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47