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Wisconsin 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 $1,000 · 10th–90th $186–$3,1620%5%10%10th90th$1,000Professionalmedian $427 · 10th–90th $257–$5890%20%10th90th$427$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$186.21 / $398.11 / $14,454.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $588.84 / $933.25
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $446.68 / $3,801.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $616.60 / $1,778.28
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $933.25 / $2,344.23
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $426.58 / $588.84
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $1,318.26
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,584.89 / $2,187.76