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North Carolina 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
$447.74 / $1,849.00 / $12,615.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$606.10 / $606.10 / $16,345.87
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$447.74 / $547.53 / $761.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,317.00 / $13,946.00 / $21,454.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $47,150.64 / $54,020.20