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Montana 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 $407 · 10th–90th $100$3,0900%20%10th90th$407Professionalmedian $182 · 10th–90th $56$6170%10%10th90th$182$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$575.44 / $2,454.71 / $3,090.30
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$512.86 / $1,513.56 / $3,548.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $177.83 / $741.31
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$81.28 / $186.21 / $467.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $77,624.71 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $91.20 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $100.00 / $323.59
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $123.03 / $426.58
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $123.03 / $426.58
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $199.53 / $363.08
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $147.91 / $323.59