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Arizona 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 $1,349 · 10th–90th $95$4,7860%10%10th90th$1,349Professionalmedian $120 · 10th–90th $50$5250%10%10th90th$120$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
$190.55 / $2,290.87 / $5,623.41
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$478.63 / $1,000.00 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $104.71 / $512.86
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$72.44 / $173.78 / $549.54
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $79.43 / $109.65
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$63.10 / $125.89 / $138.04
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $489.78 / $912.01
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $64.57 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $87.10 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $95.50 / $1,412.54
Medica
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,089.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,122.02 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $77.62 / $131.83
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$75.86 / $75.86 / $89.13