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Pennsylvania rates for HCPCS 64628

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

Facilitymedian $6,166 · 10th–90th $1,148$10,7150%10%10th90th$6,166$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
$1,047.13 / $6,165.95 / $10,715.19
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20,417.38 / $21,379.62 / $57,543.99
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,511.38 / $23,442.29 / $38,018.94
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $4,786.30 / $9,549.93
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $501.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $6,309.57 / $40,738.03