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South Dakota 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 $1,698 · 10th–90th $141$3,5480%10%10th90th$1,698Professionalmedian $204 · 10th–90th $60$1,0000%5%10th90th$204$50.0$100.0$200.0$500.0$1.0K$2.0K$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
$141.25 / $1,659.59 / $3,548.13
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,548.82 / $2,290.87 / $3,548.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $213.80 / $1,202.26
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$81.28 / $190.55 / $1,000.00
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $67.61 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $229.09 / $707.95
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $295.12 / $446.68
Medica
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $3,548.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $371.54 / $1,778.28
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $141.25 / $389.05
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $134.90 / $389.05
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $281.84 / $457.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $186.21 / $489.78
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $138.04 / $549.54