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Alaska rates for HCPCS 64494

Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level (List separately in addition to code for primary procedure)

Facilitymedian $977 · 10th–90th $91–$3,2360%10%20%10th90th$977Professionalmedian $117 · 10th–90th $52–$3630%10%10th90th$117$1.0$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
$524.81 / $1,318.26 / $7,079.46
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$177.83 / $1,698.24 / $1,949.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $91.20 / $257.04
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$75.86 / $213.80 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $134.90 / $288.40
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $239.88 / $2,238.72
Moda Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$0.98 / $1,698.24 / $3,388.44
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $223.87 / $457.09
Moda Health
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$75.86 / $213.80 / $2,884.03
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $338.84 / $467.74
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $141.25 / $426.58
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $104.71 / $223.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $144.54 / $457.09