go back

South Dakota 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 $1,349 · 10th–90th $195$3,8020%10%20%10th90th$1,349Professionalmedian $339 · 10th–90th $112$2,2390%5%10th90th$339$100.0$200.0$500.0$1.0K$2.0K$5.0K

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 / $1,348.96 / $3,388.44
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,318.26 / $2,818.38 / $4,466.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $234.42 / $2,238.72
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$263.03 / $691.83 / $5,754.40
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $213.80 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $407.38 / $575.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $257.04 / $446.68
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $407.38 / $3,467.37
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $245.47 / $436.52
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $239.88 / $426.58
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $269.15 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,659.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $245.47 / $512.86
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $245.47 / $457.09