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Hawaii 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 $2,884 · 10th–90th $1,000–$2,8840%50%10th$2,884Professionalmedian $93 · 10th–90th $49–$1780%10%10th90th$93$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$1,000.00 / $2,884.03 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $87.10 / $151.36
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$117.49 / $177.83 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $104.71 / $141.25
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $102.33 / $131.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $109.65 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $102.33 / $125.89
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $70.79 / $123.03