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Indiana 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 $66$3,5480%5%10%10th90th$977Professionalmedian $112 · 10th–90th $50$4900%10%10th90th$112$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$72.44 / $912.01 / $3,801.89
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$588.84 / $2,089.30 / $3,548.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $97.72 / $537.03
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$74.13 / $154.88 / $501.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $63.10 / $83.18
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$60.26 / $87.10 / $125.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $977.24 / $3,388.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $63.10 / $102.33
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$63.10 / $95.50 / $154.88
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $57.54 / $67.61
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $107.15 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $89.13 / $147.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $2,290.87 / $8,128.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $79.43 / $144.54
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03