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Texas 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
$95.57 / $2,000.00 / $6,762.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.40 / $86.02 / $137.99
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$132.35 / $159.91 / $457.57
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.85 / $53.85 / $65.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.43 / $977.71 / $3,989.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.79 / $88.96 / $131.15
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.79 / $59.79 / $59.79
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $93.62 / $119.45
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.53 / $358.85 / $358.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.18 / $102.18 / $102.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.20 / $108.61 / $174.10
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $55.00 / $291.98
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.00 / $2,500.00 / $2,500.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.57 / $95.84 / $159.74
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.27 / $108.62 / $170.01
Moda Health
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$109.62 / $112.47 / $117.12
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.73 / $96.24 / $136.68
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.74 / $96.58 / $161.44
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.20 / $112.20 / $187.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.00 / $950.00 / $2,405.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.09 / $103.83 / $168.11
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.61 / $91.28 / $127.93