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Massachusetts 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
$186.21 / $1,819.70 / $3,548.13
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$208.93 / $1,778.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $199.53 / $776.25
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$83.18 / $257.04 / $1,148.15
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $630.96 / $2,818.38
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $190.55 / $691.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $67.61 / $158.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $288.40 / $660.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $154.88 / $537.03
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $177.83 / $7,079.46
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $363.08 / $457.09
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $2,041.74 / $3,467.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $223.87 / $645.65
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $1,318.26 / $1,949.84
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $186.21 / $194.98
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $630.96 / $2,818.38
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $190.55 / $676.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $1,862.09 / $2,818.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $177.83 / $588.84