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Texas 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 $1,585 · 10th–90th $85$5,6230%5%10th90th$1,585Professionalmedian $79 · 10th–90th $47$1620%20%10th90th$79$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
$537.03 / $2,187.76 / $6,918.31
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$776.25 / $1,513.56 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $81.28 / $154.88
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$77.62 / $177.83 / $398.11
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $56.23 / $91.20
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$83.18 / $151.36 / $245.47
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $380.19 / $3,801.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $72.44 / $112.20
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $125.89 / $158.49
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $316.23 / $316.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $95.50 / $165.96
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $323.59
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $2,511.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $117.49 / $2,818.38
Moda Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$776.25 / $1,513.56 / $2,511.89
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $87.10 / $177.83
Moda Health
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$79.43 / $177.83 / $630.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $32.36 / $72.44
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $3,019.95 / $3,311.31
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $95.50 / $169.82
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $95.50 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $954.99 / $2,398.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $75.86 / $131.83
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$91.20 / $194.98 / $194.98
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $97.72 / $100.00