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Alabama rates for HCPCS 64495

Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; third and any additional level(s) (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $1,096.48 / $1,737.80
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$407.38 / $794.33 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $91.20 / $186.21
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$158.49 / $281.84 / $489.78
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $91.20 / $91.20
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$117.49 / $117.49 / $125.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,412.54 / $1,905.46
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,778.28 / $2,089.30 / $2,818.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $87.10 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $89.13 / $181.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $588.84 / $1,548.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $75.86 / $158.49