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Washington rates for HCPCS 64625

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

Facilitymedian $1,445 · 10th–90th $372$16,9820%5%10th90th$1,445Professionalmedian $490 · 10th–90th $214$1,1750%5%10th90th$490$50.0$200.0$1.0K$5.0K$20.0K

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
$389.05 / $5,248.07 / $18,620.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $478.63 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $5,128.61 / $10,471.29
Asuris Northwest Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$6,309.57 / $7,762.47 / $15,848.93
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $630.96 / $1,174.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $616.60 / $1,412.54
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $776.25 / $2,238.72
Kaiser Permanente
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$4,897.79 / $8,317.64 / $14,125.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $602.56 / $1,412.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $912.01 / $954.99
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $645.65 / $1,174.90
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $5,370.32 / $10,471.29
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$6,025.60 / $7,943.28 / $15,848.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $630.96 / $1,071.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $6,309.57 / $11,220.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $537.03 / $1,174.90
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $363.08 / $724.44