go back

California rates for HCPCS 64493

Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 1 Level

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.04 / $3,340.00 / $14,069.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,822.72 / $3,016.50 / $7,648.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.89 / $171.49 / $535.70
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$123.02 / $271.77 / $1,008.41
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.37 / $100.75 / $164.67
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$116.78 / $137.38 / $681.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,723.00 / $4,464.00 / $8,976.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.55 / $123.27 / $290.94
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$140.31 / $177.43 / $263.18
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.90 / $100.00 / $4,886.39
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.14 / $151.63 / $284.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$938.60 / $940.26 / $1,681.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.08 / $187.45 / $353.67
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.99 / $173.34 / $300.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.59 / $183.16 / $341.93
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$413.29 / $452.96 / $30,000.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $3,100.00 / $3,100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.86 / $179.76 / $290.30
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.50 / $194.13 / $420.94
Providence
Facility/Professional
Professional
Modifier
80
Low / Median / High Price
$51.53 / $54.29 / $470,400.00
Sutter Health Plus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,526.00 / $1,526.00 / $1,526.00
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.30 / $295.30 / $577.80
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.50 / $190.95 / $260.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,371.00 / $2,699.00 / $7,399.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $195.16 / $418.45