go back

Rhode Island 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
$1,513.56 / $2,187.76 / $3,981.07
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$707.95 / $4,466.84 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $199.53 / $616.60
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$154.88 / $389.05 / $1,230.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $165.96 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $190.55 / $363.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $2,454.71 / $6,025.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $169.82 / $389.05