go back

Maine rates for HCPCS 63650

Percutaneous implantation of neurostimulator electrode array, epidural

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $4,365.16 / $18,197.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $1,122.02 / $3,235.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $630.96 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $851.14 / $4,365.16
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $1,513.56 / $4,786.30
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $4,365.16 / $18,197.01
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $933.25 / $3,890.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $1,318.26 / $4,168.69