go back

California 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
$707.95 / $3,801.89 / $13,182.57
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,819.70 / $4,365.16 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $190.55 / $794.33
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$125.89 / $295.12 / $1,023.29
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $77.62 / $173.78
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$109.65 / $234.42 / $295.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $4,466.84 / $12,022.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $154.88 / $346.74
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$125.89 / $208.93 / $275.42
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.07 / $1,348.96 / $5,623.41
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $165.96 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $933.25 / $933.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $186.21 / $346.74
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $144.54 / $338.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $194.98 / $380.19
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $30,199.52 / $30,199.52
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $3,090.30 / $3,090.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $147.91 / $245.47
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $181.97 / $331.13
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $190.55 / $371.54
Sutter Health Plus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,513.56 / $1,513.56
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $295.12 / $575.44
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $213.80 / $275.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $2,754.23 / $7,585.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $147.91 / $331.13