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Maine rates for HCPCS 64625

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

Facilitymedian $3,981 · 10th–90th $3,981–$3,9810%50%100%$3,981Professionalmedian $437 · 10th–90th $191–$7590%10%10th90th$437$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $436.52 / $707.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $295.12 / $446.68
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$263.03 / $446.68 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $588.84 / $1,047.13
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $616.60 / $954.99
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $295.12 / $630.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $512.86 / $1,071.52