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New Hampshire rates for HCPCS 64625

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

Facilitymedian $3,388 · 10th–90th $1,585–$14,7910%10%10th90th$3,388Professionalmedian $468 · 10th–90th $214–$1,0470%10%10th90th$468$100.0$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
$2,398.83 / $3,388.44 / $14,791.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $426.58 / $707.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,737.80 / $3,890.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $363.08 / $549.54
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$263.03 / $549.54 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $537.03 / $1,258.93
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $9,549.93 / $9,549.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $575.44 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $9,549.93 / $9,549.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $575.44 / $1,513.56