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Michigan 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 $1,096 · 10th–90th $78–$3,6310%10%10th90th$1,096Professionalmedian $195 · 10th–90th $58–$7760%10%10th90th$195$1.0$5.0$20.0$100.0$500.0$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
$75.86 / $954.99 / $4,168.69
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$851.14 / $1,698.24 / $3,467.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $204.17 / $724.44
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$83.18 / $218.78 / $1,122.02
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $60.26 / $416.87
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$75.86 / $85.11 / $338.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $173.78 / $371.54
BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$186.21 / $186.21 / $741.31
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $85.11 / $123.03
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $288.40 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $173.78 / $338.84
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $933.25 / $4,168.69
Health Alliance Plan
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$758.58 / $1,318.26 / $3,467.37
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $208.93 / $457.09
Health Alliance Plan
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$85.11 / $251.19 / $831.76
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $173.78 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $1,202.26 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $141.25 / $263.03