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California 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
$549.54 / $4,466.84 / $15,135.61
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,412.54 / $2,630.27 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $190.55 / $812.83
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$85.11 / $190.55 / $1,096.48
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $141.25 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$158.49 / $158.49 / $158.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $4,466.84 / $12,882.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $102.33 / $302.00
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$81.28 / $147.91 / $426.58
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $794.33 / $1,995.26
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $177.83 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $173.78 / $380.19
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $64.57 / $407.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $245.47 / $512.86
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $724.44 / $1,698.24
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,949.84 / $1,949.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $194.98 / $331.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $177.83 / $416.87
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $162.18 / $467.74
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $194.98 / $575.44
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $85.11 / $281.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $1,584.89 / $6,456.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $141.25 / $302.00