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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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.79 / $89.13 / $8,511.38
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,570.40 / $2,570.40 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $85.11 / $141.25
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$380.19 / $380.19 / $630.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $134.90 / $218.78
BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$147.91 / $204.17 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $134.90 / $245.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $89.13 / $158.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $162.18 / $389.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,041.74 / $2,041.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $104.71 / $199.53