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South Carolina 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.20 / $4,897.79 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $93.33 / $177.83
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$147.91 / $162.18 / $389.05
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $91.20 / $131.83
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$218.78 / $218.78 / $218.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $588.84 / $1,071.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $107.15 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $102.33 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $117.49 / $186.21
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $154.88 / $229.09
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $104.71 / $177.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $1,202.26 / $3,548.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $91.20 / $173.78