go back

West Virginia 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $263.03 / $2,041.74
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,380.38 / $1,380.38 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $77.62 / $151.36
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$234.42 / $338.84 / $380.19
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.86 / $54.95 / $66.07
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $83.18 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $87.10 / $87.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $95.50 / $416.87
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $1,318.26 / $1,513.56
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$257.04 / $257.04 / $6,606.93
Highmark BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$112.20 / $112.20 / $112.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $457.09 / $457.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $75.86 / $151.36