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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
$912.01 / $2,818.38 / $18,620.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $10,964.78 / $40,738.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $12,302.69 / $21,877.62
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $912.01 / $4,786.30
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$204.17 / $204.17 / $204.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $4,897.79 / $11,481.54