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Connecticut rates for HCPCS 64628

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

Facilitymedian $7,413 · 10th–90th $4,365–$14,1250%10%10th90th$7,413$1.0K$2.0K$5.0K$10.0K$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
$4,365.16 / $7,079.46 / $14,125.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,912.51 / $17,378.01 / $31,622.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $21,379.62 / $26,915.35
ConnectiCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27,542.29 / $27,542.29 / $27,542.29
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $14,454.40 / $14,454.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $11,220.18 / $18,620.87