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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
$48.98 / $104.71 / $331.13
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$74.13 / $165.96 / $512.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $870.96 / $1,174.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $199.53 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $102.33 / $165.96
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $123.03 / $151.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $120.23 / $208.93