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Upper Back Cordotomy, One Side, Single Operation

Iowa rates for HCPCS 63195

Surgery for severe pain that has not responded to other treatment. Part of the bony arch of a vertebra in the chest section of the spine is removed to reach the spinal cord, and the pain-carrying pathway is cut on one side of the cord, relieving pain on the opposite side of the body. It is completed in a single operation.

Rates data updated July 2026.

Facilitymedian $5,012 · 10th–90th $2,630$6,7610%20%40%10th90th$5,012Professionalmedian $3,236 · 10th–90th $2,239$7,7620%10%20%10th90th$3,236$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Cigna
Setting
Professional
Modifier
Global
Typical Low
$3,235.94
Median
$3,235.94
Typical High
$3,981.07
Medica
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$5,011.87
Typical High
$5,248.07
Medica
Setting
Professional
Modifier
Global
Typical Low
$1,995.26
Median
$2,884.03
Typical High
$7,762.47
Midlands
Setting
Professional
Modifier
Global
Typical Low
$2,630.27
Median
$2,630.27
Typical High
$2,884.03
Midlands
Setting
Professional
Modifier
Global
Typical Low
$2,570.40
Median
$2,570.40
Typical High
$2,951.21
United
Setting
Facility
Modifier
Global
Typical Low
$6,760.83
Median
$6,760.83
Typical High
$6,760.83