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Michigan rates for HCPCS 64628

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

Facilitymedian $5,754 · 10th–90th $603–$10,4710%20%10th90th$5,754$200.0$500.0$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
$602.56 / $4,897.79 / $5,754.40
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $4,897.79 / $5,754.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $10,964.78 / $22,387.21