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Louisiana 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 $1,148 · 10th–90th $129–$3,4670%10%10th90th$1,148Professionalmedian $87 · 10th–90th $49–$1510%10%20%10th90th$87$0.0$0.2$2.0$20.0$200.0$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
$134.90 / $1,288.25 / $3,715.35
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
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 / $134.90 / $338.84
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$70.79 / $77.62 / $95.50
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $239.88 / $1,230.27
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $85.11 / $138.04
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $316.23 / $316.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $93.33 / $144.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $562.34 / $1,318.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $83.18 / $151.36
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$186.21 / $194.98 / $194.98