go back

Minnesota 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
$436.52 / $436.52 / $7,079.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,982.44 / $34,673.69 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,479.11 / $3,548.13
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $1,445.44 / $2,818.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $851.14 / $12,022.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $6,309.57 / $13,182.57