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West Virginia 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
$324.94 / $928.40 / $3,335.12
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$838.48 / $1,631.84 / $9,537.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.09 / $96.00 / $151.84
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$81.83 / $189.28 / $194.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.79 / $68.15 / $93.70
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.88 / $142.16 / $206.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.68 / $101.68 / $101.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.48 / $106.63 / $255.78
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$205.80 / $379.94 / $2,669.71
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$326.66 / $326.66 / $5,339.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.33 / $133.10 / $214.36