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Illinois rates for HCPCS 64628

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

Facilitymedian $4,365 · 10th–90th $1,023–$11,2200%5%10th90th$4,365Professionalmedian $759 · 10th–90th $437–$3,9810%5%10%10th90th$759$100.0$500.0$2.0K$10.0K$50.0K

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
$977.24 / $4,073.80 / $9,772.37
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $16,595.87 / $22,387.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,620.87 / $18,620.87 / $18,620.87
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $758.58 / $3,981.07
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $8,912.51 / $16,982.44