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Idaho rates for HCPCS 64635

Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.07 / $1,299.15 / $7,045.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,805.60 / $3,745.76 / $3,915.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.71 / $425.91 / $1,091.73
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$309.56 / $735.57 / $2,688.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,110.38 / $1,110.38 / $1,113.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.56 / $427.27 / $718.18
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.08 / $478.42 / $1,157.23
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$307.95 / $693.83 / $841.00
Moda Health
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$455.63 / $455.63 / $455.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $600.63 / $755.63
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,453.10 / $4,867.04 / $5,994.73
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$5,105.28 / $7,300.56 / $9,122.73
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.63 / $618.16 / $911.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,350.00 / $5,550.00 / $12,233.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$448.78 / $637.74 / $858.04