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Pennsylvania 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 $2,042 · 10th–90th $537$5,3700%10%10th90th$2,042Professionalmedian $191 · 10th–90th $87$6760%10%10th90th$191$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$177.83 / $1,737.80 / $4,786.30
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$891.25 / $2,454.71 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $173.78 / $489.78
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$123.03 / $288.40 / $812.83
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $138.04 / $181.97
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$117.49 / $234.42 / $269.15
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,332.54 / $9,332.54 / $9,332.54
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $50.12 / $109.65
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,691.53 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $251.19 / $338.84
Capital Blue Cross
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$257.04 / $389.05 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $173.78 / $302.00
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $323.59 / $1,584.89
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $223.87 / $316.23
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,995.26 / $4,073.80
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$954.99 / $3,235.94 / $5,248.07
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $177.83 / $239.88
Highmark BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$128.82 / $269.15 / $426.58
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,332.54 / $9,332.54 / $12,022.64
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $52.48 / $186.21
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $812.83 / $5,370.32
Martin's Point
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,187.76 / $3,311.31 / $6,760.83
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $169.82 / $354.81
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $912.01 / $6,606.93
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $288.40 / $398.11
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $169.82 / $263.03
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $165.96 / $263.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,949.84 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $158.49 / $316.23