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North Dakota 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 $91 · 10th–90th $50–$2,5700%10%20%10th90th$91Professionalmedian $126 · 10th–90th $52–$2950%10%10th90th$126$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
$0.79 / $89.13 / $8,511.38
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $89.13 / $199.53
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$199.53 / $309.03 / $380.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $134.90 / $213.80
BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$147.91 / $204.17 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $134.90 / $245.47
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $89.13 / $158.49
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $154.88 / $389.05
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,041.74 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $104.71 / $204.17