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Utah 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
$954.99 / $3,388.44 / $6,456.54
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,344.23 / $5,495.41 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $446.68 / $1,348.96
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$263.03 / $645.65 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $426.58 / $707.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $467.74
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $3,388.44 / $7,585.78
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$4,365.16 / $5,128.61 / $11,481.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $691.83 / $1,202.26
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $478.63 / $912.01
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $630.96 / $1,023.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $5,128.61 / $7,079.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $371.54 / $602.56