go back

New York rates for HCPCS 64625

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

Facilitymedian $4,074 · 10th–90th $589$10,2330%10%10th90th$4,074Professionalmedian $562 · 10th–90th $219$1,3490%10%10th90th$562$50.0$200.0$1.0K$5.0K$20.0K

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
$316.23 / $3,801.89 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $489.78 / $1,148.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,786.30 / $9,549.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $524.81 / $1,380.38
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$645.65 / $794.33 / $1,949.84
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $1,698.24 / $6,165.95
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $660.69 / $1,949.84
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $223.87 / $676.08
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $812.83 / $1,047.13
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $588.84 / $870.96
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $691.83 / $1,202.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,981.07 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $575.44 / $1,258.93
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $229.09 / $323.59
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $501.19 / $870.96