go back

Maryland 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
$0.98 / $21.88 / $831.76
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$0.98 / $489.78 / $489.78
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
$85.11 / $190.55 / $1,148.15
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $63.10 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $331.13 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $169.82 / $389.05
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $302.00 / $407.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $40.74 / $128.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $131.83 / $302.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $309.03 / $398.11