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Michigan 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 $776 · 10th–90th $69$2,0420%10%10th90th$776Professionalmedian $112 · 10th–90th $50$4680%10%10th90th$112$1.0$5.0$20.0$100.0$500.0$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
$67.61 / $602.56 / $2,041.74
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$660.69 / $1,202.26 / $1,949.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $97.72 / $331.13
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$74.13 / $154.88 / $575.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $83.18 / $162.18
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$64.57 / $64.57 / $104.71
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $46.77
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $102.33 / $151.36
BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$162.18 / $162.18 / $288.40
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $74.13 / $107.15
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $114.82 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $79.43 / $134.90
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $562.34 / $2,041.74
Health Alliance Plan
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$660.69 / $1,047.13 / $1,949.84
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $102.33 / $208.93
Health Alliance Plan
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$74.13 / $144.54 / $512.86
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $75.86 / $123.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $1,202.26 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $81.28 / $125.89
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03