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New Hampshire rates for HCPCS 63664

Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, 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
$10,334.70 / $11,483.00 / $21,862.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.29 / $3,906.58 / $4,043.31
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$100.85 / $100.85 / $100.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,399.00 / $12,399.00 / $12,399.00