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Virginia 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 $1,175 · 10th–90th $112–$4,6770%5%10th90th$1,175Professionalmedian $195 · 10th–90th $89–$6310%5%10%10th90th$195$20.0$100.0$500.0$2.0K$10.0K

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
$154.88 / $1,047.13 / $5,248.07
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,000.00 / $2,238.72 / $4,786.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $181.97 / $467.74
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$147.91 / $346.74 / $1,096.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,570.40 / $2,951.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $131.83 / $223.87
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$128.82 / $199.53 / $331.13
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $177.83 / $309.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $239.88 / $281.84
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $263.03 / $416.87
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $169.82 / $295.12
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $117.49 / $2,691.53
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $223.87 / $2,691.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,905.46 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $154.88 / $363.08