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Washington, DC 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
$212.59 / $2,001.74 / $4,477.39
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,103.66 / $2,228.01 / $4,762.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.29 / $171.49 / $436.10
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$29.57 / $30.05 / $654.15
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.57 / $100.75 / $1,410.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.08 / $226.48 / $471.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.64 / $415.77 / $415.77
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$665.00 / $762.00 / $6,342.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.69 / $335.87 / $499.37