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Maryland rates for HCPCS 61791

Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,288.25 / $2,951.21
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,202.26 / $1,445.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $977.24 / $977.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,479.11 / $2,951.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,380.38 / $2,041.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $1,621.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,318.26 / $2,344.23
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,513.56 / $1,819.70