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Montana rates for HCPCS 64628

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

Facilitymedian $724 · 10th–90th $575–$9330%50%10th90th$724$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
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $724.44 / $794.33
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $549.54 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63