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Louisiana 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
$143.47 / $964.15 / $3,443.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$837.00 / $2,392.36 / $3,749.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.21 / $159.12 / $279.32
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$138.32 / $192.95 / $457.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.98 / $106.87 / $157.97
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$126.26 / $166.02 / $442.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.35 / $1,242.89 / $1,951.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.48 / $167.38 / $268.67
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.05 / $957.23 / $957.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.00 / $400.00 / $400.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.80 / $164.79 / $276.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$341.00 / $1,086.00 / $2,755.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.88 / $212.15 / $399.15