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Virginia 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
$239.88 / $3,235.94 / $8,511.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $645.65 / $645.65
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $194.98 / $234.42
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $257.04 / $389.05
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $281.84 / $1,288.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $1,202.26 / $2,454.71