go back

Wisconsin 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 $1,122 · 10th–90th $83$6,1660%10%10th90th$1,122Professionalmedian $129 · 10th–90th $59$3390%5%10%10th90th$129$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
$54.95 / $630.96 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $95.50 / $239.88
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$128.82 / $288.40 / $524.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,584.89 / $6,165.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $128.82 / $288.40
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$131.83 / $194.98 / $436.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $302.00 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $229.09 / $446.68
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $123.03 / $3,311.31
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $173.78 / $269.15
DeanCare
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$165.96 / $263.03 / $407.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $128.82 / $1,659.59
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $194.98 / $2,511.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $891.25 / $2,344.23
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $190.55 / $309.03
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $177.83 / $338.84
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $2,630.27
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $371.54 / $2,511.89
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $346.74
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $346.74 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,584.89 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $131.83 / $346.74