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Michigan 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
$263.03 / $2,041.74 / $4,897.79
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,096.48 / $2,630.27 / $6,760.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $416.87 / $1,288.25
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$302.00 / $645.65 / $2,754.23
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $245.47 / $426.58
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$245.47 / $371.54 / $630.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $426.58 / $426.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $426.58 / $691.83
BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$457.09 / $457.09 / $1,047.13
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $281.84 / $398.11
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $537.03 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $363.08 / $724.44
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $1,479.11 / $4,265.80
Health Alliance Plan
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,096.48 / $2,630.27 / $5,370.32
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $457.09 / $870.96
Health Alliance Plan
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$281.84 / $707.95 / $2,691.53
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $323.59 / $660.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $3,981.07 / $7,244.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $380.19 / $588.84