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California rates for HCPCS 64634

Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $4,786.30 / $15,848.93
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$144.54 / $2,137.96 / $3,801.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $208.93 / $812.83
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$147.91 / $208.93 / $575.44
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $208.93 / $346.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $4,466.84 / $12,882.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $117.49 / $346.74
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$93.33 / $165.96 / $457.09
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $275.42 / $691.83
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $199.53 / $416.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $190.55 / $407.38
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $74.13 / $426.58
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $257.04 / $537.03
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $56.23 / $776.25
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,089.30 / $2,089.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $208.93 / $346.74
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $194.98 / $436.52
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $181.97 / $501.19
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $630.96
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $95.50 / $302.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $1,584.89 / $6,456.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $158.49 / $331.13