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Louisiana 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $1,258.93 / $3,467.37
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$288.40 / $851.14 / $2,344.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $91.20 / $389.05
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$74.13 / $138.04 / $501.19
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $52.48 / $83.18
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$66.07 / $85.11 / $141.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $239.88 / $1,230.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $85.11 / $138.04
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $309.03 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $89.13 / $144.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $512.86 / $1,258.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $81.28 / $151.36