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Texas 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
$488.00 / $2,236.00 / $7,513.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,845.00 / $5,646.00 / $8,585.00
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.29 / $165.29 / $168.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.17 / $224.17 / $224.17
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $55.00 / $946.34
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.05 / $216.49 / $381.83
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.56 / $221.01 / $385.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.00 / $950.00 / $2,405.00