go back

Pennsylvania 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
Facility
Modifier
Low / Median / High Price
$1,174.90 / $4,786.30 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,174.90 / $2,951.21
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,801.89 / $4,466.84 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,479.11 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,445.44 / $2,290.87
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,778.28 / $2,041.74
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,479.11 / $2,137.96
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $3,801.89 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,412.54 / $3,715.35
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $1,348.96 / $2,290.87
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,995.26 / $2,344.23
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $478.63 / $1,122.02
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $954.99 / $1,122.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $3,311.31 / $6,309.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,380.38 / $2,238.72