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Texas 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
$1,000.00 / $3,715.35 / $12,882.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,022.64 / $19,498.45 / $39,810.72
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $11,481.54 / $11,481.54
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $56.23 / $53,703.18
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $1,905.46 / $7,943.28
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $501.19 / $870.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $8,317.64 / $17,782.79