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Idaho rates for HCPCS 63663

Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $2,630.27 / $5,495.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $6,918.31 / $18,620.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,165.95 / $6,165.95 / $6,165.95
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $1,096.48 / $2,511.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,302.69 / $15,488.17 / $22,908.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $11,748.98 / $29,512.09