go back

Washington 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 $2,291 · 10th–90th $170$6,3100%10%10th90th$2,291Professionalmedian $234 · 10th–90th $89$8130%10%10th90th$234$5.0$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
$177.83 / $2,884.03 / $6,456.54
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$812.83 / $4,365.16 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $194.98 / $660.69
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$123.03 / $295.12 / $1,023.29
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $165.96 / $407.38
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$134.90 / $245.47 / $416.87
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,454.71 / $4,897.79
Asuris Northwest Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,630.27 / $3,630.78 / $7,413.10
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $239.88 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $870.96 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $223.87 / $478.63
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $223.87 / $831.76
Kaiser Permanente
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,905.46 / $3,235.94 / $6,760.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $223.87 / $512.86
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $79.43
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $331.13 / $346.74
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $245.47 / $309.03
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $245.47 / $436.52
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,511.89 / $4,897.79
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,511.89 / $3,801.89 / $7,413.10
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $239.88 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $2,754.23 / $5,011.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $213.80 / $398.11
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $169.82 / $275.42