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New Hampshire 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
$100.00 / $100.00 / $9,859.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,992.79 / $9,992.00 / $19,050.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$767.96 / $3,906.58 / $4,043.31
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$76.80 / $76.80 / $76.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,399.00 / $12,399.00 / $12,399.00