go back

Colorado 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
$2,551.00 / $6,028.00 / $10,651.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,990.00 / $19,587.00 / $44,198.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,641.33 / $13,641.33 / $42,970.95
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.09 / $452.63 / $680.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$444.54 / $606.20 / $808.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,284.00 / $13,659.00 / $22,505.00