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Maine 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)

Facilitymedian $933 · 10th–90th $98–$2,2910%10%10th90th$933Professionalmedian $174 · 10th–90th $62–$4470%5%10th90th$174$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $933.25 / $1,819.70
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$588.84 / $1,023.29 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $177.83 / $446.68
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$85.11 / $181.97 / $1,621.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $89.13 / $199.53
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$75.86 / $131.83 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $141.25 / $524.81
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $199.53 / $501.19
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $70.79 / $309.03
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $165.96 / $389.05
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $144.54 / $426.58