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Tennessee 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 $1,047 · 10th–90th $166$2,6920%5%10%10th90th$1,047Professionalmedian $102 · 10th–90th $49$3980%5%10%10th90th$102$10.0$50.0$200.0$1.0K$5.0K

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
$218.78 / $1,258.93 / $2,691.53
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$524.81 / $676.08 / $2,630.27
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $91.20 / $323.59
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$74.13 / $165.96 / $501.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $83.18 / $112.20
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$69.18 / $134.90 / $234.42
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $151.36 / $1,548.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $104.71 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $93.33 / $158.49
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $1,479.11 / $1,479.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $812.83 / $2,344.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $87.10 / $162.18
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13