What does Bcbsnm pay for CPT 64494 in State College, PA?

The local peer median for CPT 64494 under Bcbsnm in State College, PA is $92.30, based on 193 indexed providers. Modeled from published rates, not guaranteed.

What is the top of the local market (P90) for CPT 64494 under Bcbsnm in State College, PA?

The P90, the top of the local market and Reddenda's target rate, is $173.24.

How does Bcbsnm's rate for CPT 64494 compare to Medicare?

The Bcbsnm local median of $92.30 is 96% of Medicare's national non-facility rate of $95.86 for CPT 64494.

Reddenda · Rate Intelligence · State College, PA

64494 under Bcbsnm in State College, PA

Name: Bcbsnm rates for CPT 64494 in State College, PA
Creator: Reddenda

Facet joint injection, lumbar, second level · Local peer median $92.30 · High confidence

$92.30 local peer median. In the State College, PA market, Bcbsnm pays a local peer median of $92.30 for CPT 64494 (Facet joint injection, lumbar, second level), based on 193 providers in Reddenda's index of Bcbsnm's own published in-network rates. The top of the local market, the P90 target, is $173.24, 88% above the median. A provider billed below the local median is being paid less than peers holding the identical Bcbsnm contract in State College, PA for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 193 providers · 194 rate records

P10

$78.46

P25

$92.30

Median

$92.30

P75

$147.25

P90 (target)

$173.24

P10$78.46

P25$92.30

Median (P50)$92.30

P75$147.25

P90 target$173.24

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $72.31 – $207.48

The local peer median for CPT 64494 under Bcbsnm in State College, PA is $92.30, drawn from 193 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsnm to publish this rate
The bottom of the local market (P10) is $78.46 and the top (P90) is $173.24; the median-to-P90 spread is $80.94.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsnm to publish this rate
The lowest published rate in this market is $72.31; the highest is $207.48.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsnm to publish this rate
This benchmark is drawn from 194 individual rate records that Bcbsnm itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsnm to publish this rate
Medicare's national non-facility rate for CPT 64494 is $95.86, making the Bcbsnm local median 96% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsnm to publish this rate
46.4% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsnm to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

193 providers bill this code to this payer in this metro.

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This is the local market for CPT 64494 (Facet joint injection, lumbar, second level) under Bcbsnm in State College, PA. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

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Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Bcbsnm's own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsnm to publish this rate. Page generated 2026-08-24 23:50 UTC; the live index is queried in real time on every request.