go back

Oregon 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 $178 · 10th–90th $91$1,3800%20%10th90th$178Professionalmedian $102 · 10th–90th $50$2570%10%20%10th90th$102$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$114.82 / $263.03 / $6,606.93
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $87.10 / $257.04
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$77.62 / $141.25 / $416.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $131.83 / $234.42
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $131.83 / $239.88
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $120.23 / $223.87
Moda Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $141.25 / $234.42
Moda Health
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$74.13 / $128.82 / $436.52
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $169.82 / $177.83
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $114.82 / $199.53
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $128.82 / $223.87
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $154.88 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $4,073.80 / $6,165.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $218.78
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13