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South Carolina 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
$549.54 / $10,471.29 / $18,197.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $398.11 / $588.84
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$309.03 / $309.03 / $309.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $2,511.89 / $4,897.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $501.19 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,513.56 / $1,513.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $524.81 / $977.24
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $467.74 / $794.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.23 / $10,964.78 / $16,982.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $467.74 / $870.96