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New Mexico 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
$75.80 / $1,000.00 / $3,337.06
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,707.48 / $1,788.77 / $2,361.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.94 / $79.30 / $272.56
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$70.41 / $148.52 / $408.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$258.42 / $919.20 / $1,544.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.75 / $74.59 / $122.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.50 / $97.79 / $158.85
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.51 / $32.34 / $136.46
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.49 / $79.30 / $131.91
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.13 / $98.19 / $173.41
Providence
Facility/Professional
Professional
Modifier
80
Low / Median / High Price
$27.12 / $32.14 / $52.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.00 / $1,158.00 / $1,401.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.06 / $132.08 / $204.94