go back

South Carolina 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 $1,000 · 10th–90th $105$4,8980%20%10th90th$1,000Professionalmedian $100 · 10th–90th $50$2450%10%10th90th$100$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
$104.71 / $1,288.25 / $7,943.28
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$707.95 / $1,348.96 / $1,584.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $87.10 / $223.87
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$72.44 / $128.82 / $269.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $83.18 / $91.20
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$91.20 / $131.83 / $186.21
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $602.56 / $1,071.52
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $100.00 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $102.33 / $169.82
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $97.72 / $165.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $1,174.90 / $4,677.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $77.62 / $144.54
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03