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Wyoming 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
$537.03 / $537.03 / $1,258.93
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$537.03 / $537.03 / $1,862.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $208.93 / $1,698.24
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$281.84 / $549.54 / $5,754.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $977.24 / $977.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $407.38 / $630.96
BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$208.93 / $380.19 / $933.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $245.47 / $446.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $794.33 / $3,235.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $316.23 / $588.84