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Texas rates for HCPCS 64625

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

Facilitymedian $3,388 · 10th–90th $676$10,0000%5%10%10th90th$3,388Professionalmedian $407 · 10th–90th $178$7410%10%10th90th$407$50.0$200.0$1.0K$5.0K

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
$1,000.00 / $3,715.35 / $12,882.50
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $426.58 / $707.95
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,754.23 / $5,754.40
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $338.84 / $588.84
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $1,380.38 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $501.19 / $870.96
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $5,370.32
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $4,168.69
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $933.25 / $6,456.54
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $436.52 / $1,000.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $380.19
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $891.25 / $1,047.13
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $436.52 / $794.33
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $478.63 / $831.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $3,311.31 / $7,244.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $407.38 / $776.25
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $501.19 / $501.19