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Missouri 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 $1,318 · 10th–90th $95$4,2660%5%10th90th$1,318Professionalmedian $112 · 10th–90th $58$3550%5%10%10th90th$112$50.0$200.0$1.0K$5.0K

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
$81.28 / $1,380.38 / $5,370.32
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$537.03 / $977.24 / $1,819.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $107.15 / $346.74
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$85.11 / $169.82 / $524.81
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $51.29 / $91.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $69.18 / $112.20
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$83.18 / $104.71 / $169.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $100.00 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $107.15 / $186.21
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $107.15 / $549.54
Medica
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $162.18 / $2,754.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $707.95 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $100.00 / $169.82