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Oklahoma 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 $1,698 · 10th–90th $117$4,6770%5%10%10th90th$1,698Professionalmedian $83 · 10th–90th $48$1320%20%10th90th$83$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
$79.43 / $1,380.38 / $6,456.54
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$562.34 / $676.08 / $1,659.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $79.43 / $125.89
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$302.00 / $380.19 / $380.19
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
$128.82 / $128.82 / $151.36
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,691.53 / $4,365.16
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $87.10 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $100.00 / $141.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $104.71 / $1,548.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $102.33 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $602.56 / $1,584.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $69.18 / $114.82
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98