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Rhode Island 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
$1,513.56 / $1,548.82 / $3,981.07
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,754.23 / $2,754.23 / $5,370.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $194.98 / $416.87
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$269.15 / $457.09 / $1,148.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $177.83 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $223.87 / $398.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $2,454.71 / $6,025.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $194.98 / $426.58