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Michigan rates for HCPCS 64625

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

Facilitymedian $4,898 · 10th–90th $324–$5,2480%20%10th90th$4,898Professionalmedian $407 · 10th–90th $182–$6760%10%10th90th$407$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
$323.59 / $4,897.79 / $5,248.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $416.87 / $676.08
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $407.38 / $691.83
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $3,890.45 / $5,248.07
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $524.81 / $724.44
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $489.78 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $3,981.07 / $7,244.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $467.74 / $741.31