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Utah 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 $3,311 · 10th–90th $891–$7,0790%10%10th90th$3,311Professionalmedian $234 · 10th–90th $63–$7240%5%10th90th$234$20.0$100.0$500.0$2.0K

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
$933.25 / $3,311.31 / $7,079.46
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$891.25 / $2,754.23 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $251.19 / $758.58
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$81.28 / $190.55 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $165.96 / $371.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $169.82
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $181.97 / $478.63
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $257.04 / $407.38
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $323.59 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $141.25 / $281.84