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Vermont 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 $2,089 · 10th–90th $2,089–$2,0890%50%100%$2,089Professionalmedian $81 · 10th–90th $45–$1860%10%10th90th$81$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,089.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $72.44 / $141.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $100.00 / $169.82
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $120.23 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $117.49 / $204.17