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
$87.31 / $2,220.00 / $10,686.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$381.46 / $1,164.22 / $3,943.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.53 / $97.35 / $301.33
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$85.08 / $139.91 / $452.01
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.31 / $126.31 / $126.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,689.00 / $3,373.00 / $4,707.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.20 / $93.70 / $228.62
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$111.89 / $141.36 / $344.22
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.32 / $1,254.00 / $4,050.00
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.32 / $85.32 / $139.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.68 / $101.68 / $14,648.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.89 / $122.78 / $350.00
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.00 / $77.90 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.90 / $160.96 / $1,076.92
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.94 / $90.94 / $90.94
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.13 / $96.32 / $205.83
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.09 / $144.00 / $1,227.00
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$97.27 / $355.80 / $2,922.00
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.51 / $95.51 / $137.21
Highmark BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$205.82 / $205.82 / $206.95
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.68 / $555.00 / $36,596.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.56 / $136.81 / $346.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$964.00 / $2,826.00 / $4,851.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.92 / $132.09 / $317.01
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.83 / $68.83 / $198.91
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.44 / $124.70 / $205.83