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Indiana 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

Facilitymedian $2,089 · 10th–90th $148$5,2480%5%10th90th$2,089Professionalmedian $224 · 10th–90th $87$8510%5%10th90th$224$20.0$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $1,000.00 / $3,801.89
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$616.60 / $2,290.87 / $4,168.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $186.21 / $870.96
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$134.90 / $338.84 / $912.01
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $107.15 / $169.82
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$114.82 / $162.18 / $251.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $4,265.80 / $8,317.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $109.65 / $190.55
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$112.20 / $165.96 / $281.84
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $104.71 / $120.23
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $208.93 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $173.78 / $288.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $2,951.21 / $4,265.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $151.36 / $316.23
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$213.80 / $213.80 / $363.08