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South Dakota rates for HCPCS 63663

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

Facilitymedian $1,096 · 10th–90th $437–$8,3180%10%10th90th$1,096Professionalmedian $1,122 · 10th–90th $617–$1,7380%10%10th90th$1,122$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $912.01 / $8,317.64
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,096.48 / $1,862.09
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,047.13 / $1,862.09
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,230.27 / $1,737.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $5,370.32 / $12,882.50