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Georgia 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 $2,692 · 10th–90th $251$7,0790%10%10th90th$2,692Professionalmedian $95 · 10th–90th $51$2090%10%20%10th90th$95$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$257.04 / $3,019.95 / $7,413.10
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$251.19 / $812.83 / $1,905.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $89.13 / $186.21
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$114.82 / $223.87 / $380.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $91.20 / $190.55
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$107.15 / $151.36 / $281.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $7,943.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $89.13 / $144.54
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$91.20 / $134.90 / $213.80
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $104.71 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $109.65 / $199.53
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $114.82 / $724.44
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,760.83 / $7,079.46 / $7,079.46
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $128.82 / $162.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $1,348.96 / $2,344.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $91.20 / $181.97