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Rhode Island 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
$1,513.56 / $1,548.82 / $3,981.07
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,778.28 / $1,778.28 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $104.71 / $263.03
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$109.65 / $194.98 / $562.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $389.05 / $645.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $91.20 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $120.23 / $199.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $1,412.54 / $6,456.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $102.33 / $190.55