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Wisconsin 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 $1,995 · 10th–90th $120$5,4950%10%20%10th90th$1,995Professionalmedian $219 · 10th–90th $62$9120%10%10th90th$219$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
$229.09 / $2,884.03 / $5,495.41
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $3,467.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $223.87 / $977.24
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$81.28 / $199.53 / $977.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,584.89 / $6,165.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $151.36 / $309.03
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$128.82 / $229.09 / $457.09
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $70.79 / $95.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $758.58 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $263.03 / $954.99
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $245.47 / $3,311.31
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $199.53 / $630.96
DeanCare
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$162.18 / $302.00 / $933.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $309.03 / $1,778.28
Medica
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$776.25 / $1,047.13 / $3,630.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $338.84 / $1,778.28
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $891.25 / $2,344.23
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $288.40 / $724.44
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $281.84 / $812.83
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $724.44
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $588.84 / $1,698.24
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $891.25
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $389.05 / $1,412.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,584.89 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $208.93 / $588.84