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North Dakota 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
$89.13 / $1,318.26 / $6,456.54
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,288.25 / $3,890.45 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $173.78 / $354.81
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$131.83 / $436.52 / $933.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $257.04 / $436.52
BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$263.03 / $380.19 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $223.87 / $489.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.20 / $173.78 / $1,096.48
Medica
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,041.74 / $2,344.23 / $2,691.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $323.59 / $776.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $1,819.70 / $2,041.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $204.17 / $389.05