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Michigan rates for HCPCS 64495

Njx Dx/Ther Agt Pvrt Facet Jt Lmbr/Sac 3+ Level

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.59 / $117.34 / $4,933.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$582.16 / $582.16 / $582.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.57 / $79.47 / $146.50
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$73.88 / $129.26 / $236.96
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.14 / $79.14 / $79.14
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$118.71 / $118.71 / $118.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.58 / $467.82 / $633.82
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$216.25 / $316.91 / $413.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.95 / $76.19 / $175.25
BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$162.97 / $162.97 / $286.54
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.28 / $60.43 / $72.51
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.62 / $107.67 / $166.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.90 / $82.02 / $151.16
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.59 / $117.34 / $4,933.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$582.16 / $582.16 / $970.53
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.60 / $89.06 / $148.84
Health Alliance Plan
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$73.88 / $77.56 / $236.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.79 / $101.78 / $144.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.00 / $1,418.00 / $2,029.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.66 / $105.40 / $139.13