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Utah 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 $1,585–$11,2200%10%10th90th$4,467Professionalmedian $631 · 10th–90th $513–$8130%20%10th90th$631$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
$1,584.89 / $4,466.84 / $8,511.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,197.01 / $25,118.86 / $38,904.51
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $630.96 / $812.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $5,128.61 / $15,848.93