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Idaho 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
$218.78 / $512.86 / $5,495.41
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$660.69 / $3,715.35 / $3,890.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $204.17 / $512.86
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$138.04 / $478.63 / $1,071.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,174.90 / $2,398.83
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$933.25 / $1,737.80 / $3,548.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $281.84 / $354.81
BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$223.87 / $436.52 / $524.81
BCBS
Facility/Professional
Professional
Modifier
80
Low / Median / High Price
$23.99 / $47.86 / $56.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $169.82 / $302.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $234.42 / $537.03
Moda Health
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$660.69 / $2,691.53 / $3,890.45
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $213.80 / $398.11
Moda Health
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$134.90 / $346.74 / $1,023.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $2,041.74 / $2,951.21
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,454.71 / $3,388.44 / $4,466.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $239.88 / $371.54
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $181.97 / $977.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $2,630.27 / $4,466.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $181.97 / $331.13