go back

Missouri rates for HCPCS 64628

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

Facilitymedian $3,020 · 10th–90th $676$7,2440%5%10th90th$3,020$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
$1,778.28 / $4,897.79 / $8,511.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,819.70 / $4,168.69
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $660.69 / $7,244.36
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $4,265.80 / $12,022.64