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Oregon rates for HCPCS 64625

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

Facilitymedian $912 · 10th–90th $389–$10,7150%20%10th90th$912Professionalmedian $490 · 10th–90th $195–$1,1750%10%20%10th90th$490$100.0$500.0$2.0K$10.0K$50.0K$200.0K$1.0M

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
$389.05 / $1,071.52 / $13,803.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $478.63 / $1,071.52
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $602.56 / $1,288.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $512.86 / $1,230.27
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $588.84 / $1,258.93
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $630.96 / $1,230.27
Moda Health
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $912.01 / $954.99
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $501.19 / $1,202.26
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $575.44 / $1,288.25
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $6,760.83 / $8,128.31
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$7,244.36 / $10,000.00 / $12,302.69
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $660.69 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $8,511.38 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $575.44 / $1,230.27