go back

Virginia 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
$509.61 / $5,412.00 / $11,425.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,900.00 / $13,875.00 / $15,752.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$469.76 / $469.76 / $640.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.08 / $488.36 / $577.15
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$433.17 / $555.47 / $852.41
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.69 / $605.99 / $2,120.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,381.00 / $12,350.00 / $26,537.00