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Alaska rates for HCPCS 64491

Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; second level (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.19 / $1,770.61 / $9,577.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,760.86 / $1,841.00 / $2,065.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.09 / $284.88 / $507.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.47 / $239.24 / $417.44
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.14 / $325.61 / $637.50
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.94 / $284.33 / $571.35
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.00 / $346.00 / $536.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.14 / $325.61 / $637.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.30 / $330.60 / $536.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.84 / $373.89 / $563.84