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Montana 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
$1,148.15 / $4,265.80 / $8,511.38
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,023.29 / $3,467.37 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $426.58 / $1,819.70
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$229.09 / $616.60 / $2,754.23
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46,773.51 / $81,283.05 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $331.13 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $302.00 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $371.54 / $676.08
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $691.83 / $794.33
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $691.83 / $794.33
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $426.58 / $812.83
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $371.54 / $912.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $457.09 / $758.58