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Oregon rates for HCPCS 64628

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

Facilitymedian $813 · 10th–90th $562–$15,8490%20%10th90th$813Professionalmedian $776 · 10th–90th $589–$9770%20%10th90th$776$500.0$1.0K$2.0K$5.0K$10.0K$20.0K$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
$933.25 / $7,943.28 / $24,547.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $776.25 / $977.24
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $645.65 / $1,096.48
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $812.83 / $812.83
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $645.65 / $1,096.48
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35,481.34 / $45,708.82 / $56,234.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $21,379.62 / $56,234.13