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Arizona rates for HCPCS 64636

Dstr Nrolytc Agnt Parverteb Fct Addl Lmbr/Sacral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$449.09 / $2,116.11 / $5,431.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$748.50 / $3,300.00 / $3,990.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.29 / $172.53 / $673.28
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$81.45 / $172.72 / $494.55
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.97 / $210.17 / $586.26
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$83.96 / $265.48 / $806.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.41 / $728.08 / $1,147.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.34 / $113.40 / $185.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.55 / $147.28 / $315.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.65 / $221.23 / $1,216.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.71 / $225.06 / $901.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$716.00 / $1,535.00 / $2,175.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.25 / $202.12 / $376.25