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Idaho rates for HCPCS 61790

Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,897.00 / $4,500.00 / $7,761.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,016.44 / $1,541.39 / $2,173.98
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,403.52 / $4,867.04 / $5,994.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,550.00 / $12,152.00 / $12,233.00