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Hawaii rates for HCPCS 64625

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

Facilitymedian $5,495 · 10th–90th $1,950–$5,4950%50%10th$5,495Professionalmedian $398 · 10th–90th $182–$7080%5%10%10th90th$398$100.0$200.0$500.0$1.0K$2.0K$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
$1,949.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $389.05 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $436.52 / $1,122.02
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $398.11 / $2,454.71
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $537.03 / $676.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $380.19 / $691.83
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $263.03 / $691.83