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Indiana rates for HCPCS 64625

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

Facilitymedian $8,318 · 10th–90th $1,175–$11,2200%10%10th90th$8,318Professionalmedian $295 · 10th–90th $174–$6030%10%20%10th90th$295$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$288.40 / $4,897.79 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $389.05 / $602.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $8,912.51 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $186.21 / $295.12
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$229.09 / $275.42 / $446.68
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $309.03 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $467.74 / $758.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $6,025.60 / $14,125.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $407.38 / $831.76