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South Dakota rates for HCPCS 64625

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

Facilitymedian $479 · 10th–90th $191–$4,3650%20%10th90th$479Professionalmedian $457 · 10th–90th $191–$1,0470%10%10th90th$457$200.0$500.0$1.0K$2.0K

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
$190.55 / $478.63 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $407.38 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $575.44 / $1,380.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $512.86 / $1,122.02
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $645.65 / $1,412.54
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $1,148.15
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $467.74 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $3,981.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $549.54 / $1,288.25
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $467.74 / $1,096.48