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South Carolina 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,801.89 / $5,888.44 / $16,595.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $331.13 / $891.25
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.53 / $245.47 / $426.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $1,202.26 / $3,548.13