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Arkansas rates for HCPCS 64636

Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.89 / $1,064.00 / $2,987.84
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$731.25 / $1,309.89 / $2,495.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.79 / $165.07 / $476.14
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$79.34 / $403.02 / $1,292.75
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.67 / $92.55 / $321.82
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$128.51 / $128.51 / $142.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.38 / $97.62 / $350.80
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.59 / $76.55 / $173.21
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.16 / $254.16 / $264.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.03 / $138.34 / $371.73
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.52 / $98.52 / $98.52
Qualchoice
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$147.79 / $147.79 / $590.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.00 / $328.00 / $768.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.91 / $217.76 / $334.18