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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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $7,079.46 / $14,125.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,912.51 / $17,378.01 / $31,622.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $21,379.62 / $26,302.68
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27,542.29 / $27,542.29 / $27,542.29
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,454.40 / $14,454.40 / $14,454.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,244.36 / $10,964.78 / $18,620.87