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Alaska rates for HCPCS 64628

Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,236.00 / $9,813.00 / $14,552.94
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$421.74 / $2,166.39 / $3,032.95
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$421.74 / $2,166.39 / $3,032.95