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Michigan 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 $1,950 · 10th–90th $151$3,1620%10%10th90th$1,950Professionalmedian $209 · 10th–90th $89$7590%5%10th90th$209$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
$125.89 / $1,778.28 / $2,951.21
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,318.26 / $2,290.87 / $3,630.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $173.78 / $489.78
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$138.04 / $302.00 / $1,023.29
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $173.78
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$120.23 / $128.82 / $478.63
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $144.54 / $281.84
BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$218.78 / $218.78 / $426.58
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $131.83 / $190.55
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $223.87 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $147.91 / $257.04
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $1,412.54 / $2,951.21
Health Alliance Plan
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$776.25 / $2,089.30 / $3,090.30
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $194.98 / $354.81
Health Alliance Plan
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$134.90 / $295.12 / $1,023.29
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $144.54 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,621.81 / $3,801.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $151.36 / $275.42
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80