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Massachusetts 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
$187.29 / $1,700.06 / $3,124.50
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$348.76 / $2,482.33 / $4,833.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.29 / $170.90 / $350.35
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$155.22 / $438.75 / $1,054.20
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.88 / $1,483.60 / $7,161.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.47 / $278.95 / $776.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.86 / $136.03 / $269.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.97 / $215.86 / $448.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.12 / $229.63 / $443.56
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.96 / $300.00 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.46 / $250.67 / $346.35
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.41 / $248.25 / $523.64
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$655.04 / $1,836.18 / $3,413.34
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.07 / $278.66 / $438.63
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$452.96 / $2,078.00 / $30,000.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.04 / $418.65 / $3,100.00
Tufts
Facility/Professional
Facility
Modifier
Low / Median / High Price
$928.79 / $1,480.18 / $2,605.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,106.00 / $2,408.00 / $5,683.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.56 / $340.73 / $580.54