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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

Facilitymedian $4,467 · 10th–90th $794–$20,4170%5%10%10th90th$4,467$100.0$500.0$2.0K$10.0K$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
$1,000.00 / $3,715.35 / $12,882.50
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $19,498.45 / $39,810.72
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $15,135.61 / $15,135.61
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $691.83
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $54,954.09
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $831.76 / $6,309.57
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $501.19 / $870.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $8,128.31 / $16,595.87