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Missouri 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 $1,862 · 10th–90th $174$5,4950%10%10th90th$1,862Professionalmedian $200 · 10th–90th $87$6920%10%10th90th$200$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 / $1,698.24 / $5,754.40
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$851.14 / $2,951.21 / $5,370.32
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $173.78 / $549.54
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$125.89 / $295.12 / $977.24
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $81.28 / $162.18
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$104.71 / $134.90 / $154.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $102.33 / $169.82
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$123.03 / $154.88 / $257.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $186.21 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $186.21 / $338.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $208.93 / $2,238.72
Medica
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,737.80 / $1,905.46 / $2,290.87
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $302.00 / $3,090.30
Medica
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,047.13 / $2,089.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $162.18 / $316.23
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08