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Hawaii rates for HCPCS 64628

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

Facilitymedian $6,026 · 10th–90th $2,570–$6,0260%50%10th$6,026Professionalmedian $447 · 10th–90th $407–$5500%50%10th90th$447$500.0$1.0K$2.0K$5.0K

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
$2,570.40 / $6,025.60 / $6,025.60
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $446.68 / $549.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,019.95