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Arkansas 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)

Facilitymedian $550 · 10th–90th $95–$1,8200%10%10th90th$550Professionalmedian $87 · 10th–90th $49–$1740%5%10%10th90th$87$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$66.07 / $630.96 / $1,862.09
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$114.82 / $114.82 / $524.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $85.11 / $151.36
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$74.13 / $154.88 / $380.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $134.90
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $66.07
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $104.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $104.71 / $177.83
Qualchoice
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $165.96 / $213.80
Qualchoice
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$117.49 / $151.36 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $363.08 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $87.10 / $162.18