go back

New Mexico 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
$131.18 / $1,349.48 / $3,428.82
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,280.11 / $1,791.90 / $5,143.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.95 / $157.28 / $306.24
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$62.22 / $293.92 / $713.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$728.01 / $2,589.53 / $4,349.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.13 / $150.21 / $236.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.86 / $172.75 / $303.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $49.30 / $264.29
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.77 / $147.29 / $261.87
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.46 / $194.29 / $330.31
Providence
Facility/Professional
Professional
Modifier
80
Low / Median / High Price
$52.85 / $64.03 / $101.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$418.00 / $2,516.00 / $2,877.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.99 / $285.94 / $428.41