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Ohio 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 $933 · 10th–90th $95$4,6770%5%10%10th90th$933Professionalmedian $105 · 10th–90th $58$2290%10%10th90th$105$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$89.13 / $891.25 / $4,786.30
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$575.44 / $977.24 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $104.71 / $229.09
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$138.04 / $194.98 / $1,659.59
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $54.95 / $93.33
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$81.28 / $97.72 / $144.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,344.23 / $2,511.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $74.13 / $114.82
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$81.28 / $112.20 / $173.78
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $63.10
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $72.44 / $95.50
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $123.03 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $21,379.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $104.71 / $169.82
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $758.58 / $1,318.26
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $102.33 / $169.82
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$89.13 / $91.20 / $134.90
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $102.33 / $154.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $1,047.13 / $3,235.94
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $87.10 / $158.49