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Montana rates for HCPCS 64629

Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure)

Facilitymedian $339 · 10th–90th $257–$3720%20%40%10th90th$339$200.0$1.0K$5.0K$20.0K$100.0K

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
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $77,624.71 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $338.84 / $371.54
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $257.04 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87