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Maryland rates for HCPCS 64628

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

Facilitymedian $9,333 · 10th–90th $646–$9,3330%50%10th$9,333Professionalmedian $417 · 10th–90th $380–$6310%20%10th90th$417$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,332.54 / $9,332.54 / $9,332.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $645.65 / $8,912.51
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $416.87 / $630.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $1,000.00 / $3,548.13