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Virginia 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
$999.44 / $5,087.00 / $8,294.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,060.00 / $3,693.00 / $4,290.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$839.11 / $1,006.93 / $1,245.01
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$928.35 / $1,163.71 / $1,689.05
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$854.65 / $1,159.11 / $4,097.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,651.00 / $6,145.00 / $13,521.00