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Washington, DC 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 $1,549 · 10th–90th $93–$4,0740%10%10th90th$1,549Professionalmedian $93 · 10th–90th $50–$2750%10%10th90th$93$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$93.33 / $1,698.24 / $4,073.80
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$147.91 / $1,288.25 / $1,348.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $89.13 / $218.78
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$173.78 / $338.84 / $812.83
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $489.78 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $91.20 / $204.17
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $114.82 / $208.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $549.54 / $5,888.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $95.50 / $194.98