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Oregon 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 $457 · 10th–90th $120–$3,8900%10%10th90th$457Professionalmedian $191 · 10th–90th $59–$6920%5%10%10th90th$191$0.5$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$147.91 / $954.99 / $5,011.87
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $3,890.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $190.55 / $724.44
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$81.28 / $186.21 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $177.83 / $602.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $251.19 / $630.96
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $229.09 / $630.96
Moda Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $3,890.45
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $251.19 / $588.84
Moda Health
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$81.28 / $190.55 / $467.74
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $389.05 / $457.09
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $186.21 / $467.74
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $158.49 / $602.56
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $199.53 / $630.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $4,073.80 / $6,165.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $194.98 / $416.87