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Utah rates for HCPCS 63650

Percutaneous implantation of neurostimulator electrode array, epidural

Facilitymedian $5,623 · 10th–90th $2,754–$9,1200%10%20%10th90th$5,623Professionalmedian $1,148 · 10th–90th $398–$6,7610%10%10th90th$1,148$50.0$200.0$1.0K$5.0K$20.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $5,623.41 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $1,096.48 / $7,244.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $676.08 / $3,715.35
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,202.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,332.54 / $12,882.50 / $19,498.45
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,621.81 / $4,570.88
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $2,398.83 / $5,248.07
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $3,090.30 / $4,677.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $5,128.61 / $75,857.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $912.01 / $2,454.71