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West 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $977.24 / $3,162.28
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,698.24 / $3,235.94 / $13,489.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $186.21 / $309.03
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$263.03 / $338.84 / $758.58
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $128.82 / $177.83
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $281.84 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $177.83 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $199.53 / $891.25
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,949.84 / $3,981.07
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,412.54 / $4,897.79 / $7,585.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $691.83 / $2,454.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $154.88 / $407.38