go back

Tennessee 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
$232.18 / $1,367.00 / $3,940.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$803.00 / $2,077.48 / $2,701.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.96 / $154.91 / $271.06
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$62.22 / $293.92 / $695.27
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.23 / $106.23 / $212.60
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$159.34 / $233.57 / $436.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$764.00 / $1,483.00 / $2,244.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.90 / $175.83 / $305.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.47 / $186.52 / $297.88
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$413.29 / $452.96 / $30,000.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $3,100.00 / $3,100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$695.00 / $1,465.00 / $2,886.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.79 / $240.35 / $406.45