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Alaska rates for HCPCS 64493

Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $2,754.23 / $6,025.60
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,090.30 / $3,162.28 / $3,630.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $177.83 / $436.52
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$141.25 / $436.52 / $5,248.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $380.19 / $758.58
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.20 / $616.60 / $2,511.89
Moda Health
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,691.53 / $3,235.94 / $4,365.16
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $426.58 / $891.25
Moda Health
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$204.17 / $389.05 / $5,248.07
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $524.81 / $977.24
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $251.19 / $794.33
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $181.97 / $426.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $436.52 / $870.96