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Michigan 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
$1,154.69 / $4,112.00 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,911.81 / $2,231.66 / $3,040.13
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$944.48 / $4,112.00 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,248.00 / $5,202.00 / $7,355.00