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Wisconsin rates for HCPCS 64628

Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral

Facilitymedian $15,849 · 10th–90th $1,738–$28,8400%10%10th90th$15,849Professionalmedian $933 · 10th–90th $562–$1,2880%10%20%10th90th$933$200.0$1.0K$5.0K$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
$407.38 / $851.14 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,882.50 / $18,197.01 / $28,840.32
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,258.93 / $2,089.30
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $933.25 / $3,801.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $3,801.89 / $16,595.87
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $10,715.19 / $17,378.01
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $933.25 / $1,288.25
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19,498.45 / $36,307.81 / $53,703.18
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $1,548.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,912.51 / $14,125.38 / $17,782.79