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Nebraska 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 $2,188 · 10th–90th $93–$8,5110%10%10th90th$2,188Professionalmedian $141 · 10th–90th $55–$3980%10%10th90th$141$50.0$200.0$1.0K$5.0K$20.0K

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
$125.89 / $3,801.89 / $12,589.25
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,122.02 / $1,318.26 / $1,318.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $125.89 / $380.19
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$120.23 / $295.12 / $416.87
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,949.84 / $3,801.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $97.72 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $162.18 / $269.15
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $112.20 / $229.09
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $173.78 / $389.05
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $169.82 / $257.04
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $162.18 / $281.84
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $6,025.60 / $7,079.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,548.82 / $4,466.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $117.49 / $213.80