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Virginia 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 $813 · 10th–90th $126–$4,2660%5%10th90th$813Professionalmedian $209 · 10th–90th $105–$5010%5%10%10th90th$209$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
$177.83 / $1,023.29 / $5,248.07
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,862.09 / $2,344.23 / $4,265.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $199.53 / $478.63
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$181.97 / $338.84 / $1,819.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,570.40 / $2,951.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $151.36 / $257.04
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$151.36 / $229.09 / $389.05
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $151.36 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $194.98 / $338.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $257.04 / $302.00
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $295.12 / $457.09
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $190.55 / $316.23
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $141.25 / $2,691.53
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $251.19 / $2,691.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,905.46 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $177.83 / $398.11