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Missouri 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
$818.00 / $2,782.00 / $12,154.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,266.00 / $7,703.00 / $39,694.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,083.00 / $10,223.00 / $15,638.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$431.05 / $893.37 / $3,168.78
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$205.58 / $205.58 / $205.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,209.00 / $6,362.00 / $12,989.00