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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
$158.49 / $1,148.15 / $3,467.37
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$831.76 / $2,041.74 / $3,890.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $177.83 / $549.54
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$131.83 / $288.40 / $1,513.56
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $100.00 / $263.03
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$120.23 / $147.91 / $275.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $1,230.27 / $1,949.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $162.18 / $269.15
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $977.24 / $977.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $169.82 / $281.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $1,096.48 / $2,344.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $158.49 / $309.03