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Idaho 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 $302 · 10th–90th $85$5,4950%10%10th90th$302Professionalmedian $102 · 10th–90th $51$2190%5%10%10th90th$102$50.0$200.0$1.0K$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
$151.36 / $1,412.54 / $5,495.41
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $91.20 / $218.78
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$74.13 / $128.82 / $436.52
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $346.74 / $1,202.26
BCBS
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$218.78 / $489.78 / $1,778.28
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $123.03 / $177.83
BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$144.54 / $229.09 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $93.33 / $151.36
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $117.49 / $245.47
Moda Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,047.13
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $117.49 / $199.53
Moda Health
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$74.13 / $128.82 / $630.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $123.03 / $186.21
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $93.33 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $1,819.70 / $9,332.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $97.72 / $162.18