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Missouri 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 $1,380 · 10th–90th $78$5,1290%5%10th90th$1,380Professionalmedian $91 · 10th–90th $50$3090%5%10%10th90th$91$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
$70.79 / $1,230.27 / $5,623.41
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,148.15 / $1,548.82 / $1,548.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $89.13 / $275.42
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$93.33 / $208.93 / $489.78
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $43.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $60.26 / $97.72
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$70.79 / $91.20 / $147.91
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $97.72 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $97.72 / $173.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $95.50 / $549.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $147.91 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $707.95 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $89.13 / $154.88