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Vermont 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
Professional
Modifier
Low / Median / High Price
$46.93 / $79.12 / $104.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$874.49 / $1,370.16 / $1,485.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.05 / $224.53 / $329.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.28 / $112.06 / $201.42
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.81 / $115.72 / $201.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.82 / $144.28 / $367.76