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Pennsylvania 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 $1,950 · 10th–90th $309$5,1290%5%10%10th90th$1,950Professionalmedian $209 · 10th–90th $102$6310%10%10th90th$209$50.0$200.0$1.0K$5.0K$20.0K

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
$194.98 / $1,862.09 / $4,897.79
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$891.25 / $2,630.27 / $5,370.32
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $190.55 / $549.54
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$162.18 / $338.84 / $933.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $177.83 / $194.98
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$134.90 / $263.03 / $467.74
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $6,309.57 / $6,309.57
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $380.19
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,691.53 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $275.42 / $380.19
Capital Blue Cross
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$281.84 / $407.38 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $194.98 / $338.84
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $346.74 / $1,905.46
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $251.19 / $338.84
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $2,089.30 / $3,981.07
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,047.13 / $3,235.94 / $6,025.60
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $109.65 / $194.98
Highmark BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $6,309.57 / $6,309.57
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $257.04
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $1,202.26 / $5,370.32
Martin's Point
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,344.23 / $3,235.94 / $7,762.47
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $186.21 / $389.05
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $891.25 / $6,606.93
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $309.03 / $467.74
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $186.21 / $288.40
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $186.21 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,949.84 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $181.97 / $354.81