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Ohio 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 $2,089 · 10th–90th $204$6,3100%10%10th90th$2,089Professionalmedian $195 · 10th–90th $102$3980%10%20%10th90th$195$1.0$5.0$20.0$100.0$500.0$2.0K$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
$165.96 / $1,819.70 / $4,786.30
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$676.08 / $2,818.38 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $194.98 / $407.38
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$263.03 / $338.84 / $758.58
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $95.50 / $186.21
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$144.54 / $186.21 / $288.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $2,238.72 / $3,981.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $128.82 / $208.93
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$141.25 / $194.98 / $309.03
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $128.82 / $169.82
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $234.42 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $194.98 / $338.84
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,023.29 / $2,511.89
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $194.98 / $338.84
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$234.42 / $245.47 / $398.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $58.88
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $537.03
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $204.17 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,862.09 / $4,073.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $165.96 / $331.13