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Indiana 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 $776 · 10th–90th $72$4,4670%5%10th90th$776Professionalmedian $87 · 10th–90th $48$3310%10%10th90th$87$50.0$200.0$1.0K$5.0K$20.0K

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
$74.13 / $776.25 / $4,897.79
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$549.54 / $616.60 / $1,659.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $87.10 / $302.00
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$70.79 / $199.53 / $380.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $66.07 / $89.13
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $977.24 / $3,388.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $64.57 / $100.00
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$64.57 / $97.72 / $151.36
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $58.88 / $66.07
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $107.15 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $91.20 / $147.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $2,290.87 / $8,128.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $79.43 / $144.54