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Washington 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 $389 · 10th–90th $78–$4,7860%5%10th90th$389Professionalmedian $219 · 10th–90th $60–$9770%5%10%10th90th$219$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
$109.65 / $912.01 / $9,772.37
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$575.44 / $1,778.28 / $2,884.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $223.87 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$85.11 / $398.11 / $1,148.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $93.33 / $389.05
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$125.89 / $234.42 / $562.34
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,659.59
Asuris Northwest Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,454.71
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $190.55 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $707.95 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $177.83 / $645.65
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $154.88 / $524.81
Kaiser Permanente
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $158.49 / $524.81
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $338.84 / $457.09
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $338.84 / $338.84
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $331.13 / $575.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,659.59
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $2,454.71
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $190.55 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $549.54 / $5,754.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $181.97 / $426.58
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $102.33 / $371.54