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Maryland rates for HCPCS 64492

Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; third and any additional level(s) (List separately in addition to code for primary procedure)

Facilitymedian $191 · 10th–90th $2–$4070%10%20%10th90th$191Professionalmedian $100 · 10th–90th $58–$2950%10%20%10th90th$100$2.0$10.0$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $190.55 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $95.50 / $275.42
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$128.82 / $190.55 / $457.09
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $66.07 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $102.33 / $190.55
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $123.03 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $40.74 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $95.50 / $173.78
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $154.88