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Vermont 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
$2,511.89 / $2,511.89 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $112.20 / $263.03
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$81.28 / $194.98 / $562.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $1,905.46 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $109.65 / $181.97
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $131.83 / $162.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $131.83 / $223.87