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Oregon 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 $380 · 10th–90th $257–$5,0120%20%40%10th90th$380Professionalmedian $355 · 10th–90th $269–$4570%20%10th90th$355$200.0$500.0$1.0K$2.0K$5.0K

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
$436.52 / $4,786.30 / $7,943.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $354.81 / $457.09
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $302.00 / $512.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $380.19 / $380.19
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $302.00 / $512.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $4,073.80 / $6,165.95