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Nationwide rates for HCPCS 64625

Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)

Facilitymedian $4,467 · 10th–90th $589–$10,7150%5%10%10th90th$4,467Professionalmedian $468 · 10th–90th $186–$1,1220%10%10th90th$468$2.0$20.0$200.0$2.0K$20.0K$200.0K

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
$549.54 / $4,570.88 / $11,220.18
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $4,786.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $436.52 / $1,023.29
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $5,248.07 / $12,022.64
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $316.23 / $812.83
BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$263.03 / $446.68 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $1,513.56 / $4,265.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $549.54 / $1,202.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $3,981.07 / $9,120.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $489.78 / $1,000.00

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