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West Virginia 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
$487.40 / $2,449.64 / $3,195.06
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$487.39 / $824.38 / $4,083.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.08 / $80.20 / $152.53
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$72.56 / $161.76 / $167.03
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.37 / $58.04 / $79.81
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.26 / $130.93 / $189.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.87 / $86.87 / $86.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.44 / $98.19 / $234.46
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.94 / $492.16 / $2,548.56
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$338.52 / $636.36 / $5,688.57
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.98 / $76.98 / $76.98
Highmark BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$105.29 / $105.29 / $105.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.73 / $113.82 / $170.74