go back

New Mexico 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
$70.79 / $154.88 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $85.11 / $275.42
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$120.23 / $398.11 / $416.87
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $91.20 / $91.20
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$66.07 / $70.79 / $138.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $933.25 / $1,548.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $81.28 / $123.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $97.72 / $199.53
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $75.86
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $95.50 / $165.96
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $100.00 / $169.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $1,096.48 / $1,412.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $100.00 / $158.49