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Utah 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)

Facilitymedian $3,162 · 10th–90th $692–$5,2480%10%10th90th$3,162Professionalmedian $240 · 10th–90th $68–$7940%5%10th90th$240$50.0$100.0$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
$691.83 / $3,311.31 / $5,248.07
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$954.99 / $1,949.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $263.03 / $831.76
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$97.72 / $162.18 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $173.78 / $398.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $181.97
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $208.93 / $512.86
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $275.42 / $436.52
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $346.74 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $154.88 / $309.03