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Maryland 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)

Facilitymedian $186 · 10th–90th $1–$4070%10%10th90th$186Professionalmedian $112 · 10th–90th $58–$3470%10%10th90th$112$1.0$5.0$20.0$100.0$500.0$2.0K

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
$1.95 / $275.42 / $407.38
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$0.98 / $0.98 / $1.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $104.71 / $338.84
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$87.10 / $186.21 / $416.87
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $64.57 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $102.33 / $190.55
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $123.03 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $40.74 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $95.50 / $173.78
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $154.88