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Idaho 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
$175.23 / $343.20 / $2,350.03
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$244.80 / $397.81 / $1,055.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.53 / $96.53 / $237.45
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$89.90 / $146.91 / $508.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.61 / $110.36 / $167.69
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.65 / $136.59 / $249.32
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.01 / $143.94 / $189.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $135.83 / $170.88
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.24 / $140.55 / $199.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.00 / $1,800.00 / $9,193.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.36 / $144.15 / $193.11