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South Carolina 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 $1,000 · 10th–90th $100$7,9430%10%20%10th90th$1,000Professionalmedian $85 · 10th–90th $49$1620%5%10%10th90th$85$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
$144.54 / $1,445.44 / $9,772.37
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$524.81 / $707.95 / $1,548.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $79.43 / $147.91
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$93.33 / $134.90 / $186.21
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $93.33
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $588.84 / $1,071.52
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $100.00 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $104.71 / $173.78
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $97.72 / $169.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $1,174.90 / $4,677.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $77.62 / $144.54