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North Carolina 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 $661 · 10th–90th $76–$2,9510%10%10th90th$661Professionalmedian $93 · 10th–90th $50–$2630%10%20%10th90th$93$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$83.18 / $851.14 / $5,248.07
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$549.54 / $2,951.21 / $2,951.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $87.10 / $190.55
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$74.13 / $173.78 / $436.52
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$109.65 / $114.82 / $125.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $151.36 / $223.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $104.71 / $181.97
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $213.80
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $89.13 / $151.36
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $2,691.53
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $134.90 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $794.33 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $85.11 / $162.18
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $323.59 / $2,630.27
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $2,511.89