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Idaho 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
$173.78 / $2,951.21 / $8,128.31
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$707.95 / $8,128.31 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $190.55 / $691.83
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$83.18 / $213.80 / $977.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $870.96 / $2,344.23
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$512.86 / $1,288.25 / $2,238.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $316.23 / $457.09
BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$147.91 / $177.83 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $169.82 / $302.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $239.88 / $3,090.30
Moda Health
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$707.95 / $3,235.94 / $8,709.64
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $173.78 / $501.19
Moda Health
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$81.28 / $186.21 / $831.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $144.54 / $478.63
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $234.42 / $489.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $1,819.70 / $9,332.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $141.25 / $323.59