| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,464.00 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $563.78 | $2,418.88 | $5,745.94 | |
Providence
| Facility | $563.78 | $2,418.88 | $5,745.94 |
Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,464.00 | $6,541.00 | $13,413.92 | |
Moda Health
| Facility | $563.78 | $2,418.88 | $5,745.94 | |
Providence
| Facility | $563.78 | $2,418.88 | $5,745.94 |