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Maryland 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 $550 · 10th–90th $78–$2,2910%10%10th90th$550Professionalmedian $195 · 10th–90th $87–$6170%10%10th90th$195$1.0$5.0$20.0$100.0$500.0$2.0K

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
$56.23 / $407.38 / $2,290.87
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$102.33 / $691.83 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $181.97 / $467.74
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$123.03 / $281.84 / $812.83
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $100.00 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $446.68 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $177.83 / $338.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $229.09 / $346.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $123.03 / $426.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $162.18 / $338.84
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$89.13 / $89.13 / $363.08
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $234.42 / $288.40