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Tennessee 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 $1,148 · 10th–90th $166$2,6920%10%10th90th$1,148Professionalmedian $85 · 10th–90th $49$2000%10%10th90th$85$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
$467.74 / $1,380.38 / $3,981.07
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $83.18 / $173.78
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$93.33 / $173.78 / $436.52
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $56.23 / $109.65
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$70.79 / $138.04 / $239.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $151.36 / $1,548.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $104.71 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $95.50 / $154.88
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $323.59 / $2,630.27
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $812.83 / $2,344.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $87.10 / $162.18