go back

Oklahoma 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
$119.08 / $2,024.00 / $6,422.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$535.50 / $1,878.50 / $2,958.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.42 / $85.46 / $102.43
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$82.89 / $82.89 / $82.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,832.80 / $2,927.28 / $4,626.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.19 / $93.45 / $128.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.17 / $102.87 / $153.57
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.06 / $94.45 / $1,130.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.44 / $115.83 / $2,750.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.00 / $610.00 / $1,883.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.53 / $105.03 / $159.00