go back

Utah 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 $3,388 · 10th–90th $1,698–$4,5710%20%10th90th$3,388Professionalmedian $288 · 10th–90th $245–$3720%20%10th90th$288$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
$1,698.24 / $3,388.44 / $4,570.88
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $288.40 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61