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Oklahoma rates for HCPCS 64625

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $2,630.27 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $363.08 / $562.34
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $165.96 / $707.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $5,623.41 / $9,120.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $467.74 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $549.54 / $691.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $1,380.38 / $5,754.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $588.84 / $4,168.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $3,235.94 / $5,754.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $389.05 / $676.08