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Ohio 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 $1,995 · 10th–90th $282$5,6230%5%10%10th90th$1,995Professionalmedian $135 · 10th–90th $56$4370%10%10th90th$135$1.0$5.0$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
$234.42 / $1,862.09 / $5,495.41
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$977.24 / $2,511.89 / $5,754.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $177.83 / $446.68
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$83.18 / $190.55 / $691.83
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $56.23 / $208.93
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$69.18 / $89.13 / $302.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,137.96 / $2,511.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $72.44 / $120.23
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$81.28 / $107.15 / $181.97
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $100.00
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $72.44 / $95.50
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $281.84 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $131.83 / $346.74
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $1,000.00 / $1,995.26
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $125.89 / $346.74
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$57.54 / $57.54 / $93.33
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $33.11 / $33.11
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $186.21 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $1,047.13 / $3,235.94
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $123.03 / $281.84