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South Dakota 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 $437–$4,8980%20%10th90th$724Professionalmedian $708 · 10th–90th $562–$1,0470%20%10th90th$708$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

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
$436.52 / $4,365.16 / $4,897.79
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $20,892.96 / $20,892.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $691.83 / $933.25
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,047.13 / $1,047.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $707.95 / $891.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $5,370.32 / $5,370.32