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Tennessee 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$343.45 / $2,303.00 / $5,440.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$601.90 / $1,339.88 / $1,539.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.50 / $161.80 / $319.55
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$82.31 / $405.25 / $931.50
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.50 / $69.50 / $69.50
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$80.31 / $305.00 / $429.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.00 / $147.00 / $1,676.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.29 / $150.04 / $294.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.45 / $160.72 / $344.05
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $429.16 / $429.16
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$871.44 / $1,679.92 / $1,965.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.00 / $808.00 / $2,577.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.52 / $214.95 / $379.70