go back

New York 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
$107.15 / $2,630.27 / $9,549.93
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$208.93 / $2,089.30 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $109.65 / $389.05
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$89.13 / $194.98 / $489.78
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $56.23 / $91.20
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$85.11 / $104.71 / $147.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $3,630.78 / $5,011.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $93.33 / $251.19
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$114.82 / $141.25 / $380.19
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $1,258.93 / $4,073.80
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $102.33 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $125.89 / $398.11
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $64.57 / $169.82
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $165.96 / $338.84
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $91.20 / $91.20
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $125.89 / $204.17
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $208.93 / $1,288.25
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$97.72 / $295.12 / $354.81
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $138.04 / $138.04
Highmark BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$208.93 / $208.93 / $208.93
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.70 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $165.96 / $398.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $2,754.23 / $4,897.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $102.33 / $251.19
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.86 / $69.18 / $173.78
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $117.49 / $204.17