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Missouri 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 $1,660 · 10th–90th $178–$5,0120%5%10th90th$1,660Professionalmedian $166 · 10th–90th $58–$6920%5%10th90th$166$20.0$100.0$500.0$2.0K$10.0K

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
$87.10 / $1,698.24 / $5,623.41
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$831.76 / $1,778.28 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $181.97 / $691.83
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$83.18 / $144.54 / $977.24
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $56.23 / $208.93
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$67.61 / $85.11 / $346.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,819.70 / $3,981.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $67.61 / $112.20
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$81.28 / $102.33 / $169.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $218.78 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $154.88 / $354.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $223.87 / $630.96
Medica
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $295.12 / $1,778.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $707.95 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $147.91 / $316.23