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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
Professional
Modifier
Low / Median / High Price
$55.09 / $69.67 / $111.23
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,365.98 / $2,365.98 / $2,554.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.89 / $213.89 / $213.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.34 / $121.02 / $216.04
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.37 / $125.59 / $216.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.52 / $159.18 / $394.45