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Maryland rates for HCPCS 64625

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

Facilitymedian $832 · 10th–90th $372–$3,9810%10%10th90th$832Professionalmedian $427 · 10th–90th $182–$9330%10%10th90th$427$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $426.58 / $1,023.29
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $204.17 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $489.78 / $1,000.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $575.44 / $794.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $501.19 / $3,981.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $457.09 / $851.14
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $524.81 / $758.58