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Utah rates for HCPCS 64624

Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed

Facilitymedian $3,388 · 10th–90th $562–$5,8880%10%10th90th$3,388Professionalmedian $398 · 10th–90th $145–$1,2590%10%10th90th$398$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
$562.34 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $407.38 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $331.13 / $676.08
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $891.25
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,801.89 / $5,888.44
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$4,168.69 / $5,754.40 / $8,709.64
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $457.09 / $912.01
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $426.58 / $676.08
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $524.81 / $812.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $7,079.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $316.23 / $588.84