go back

Pennsylvania 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
$906.70 / $2,561.00 / $9,119.23
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,058.35 / $6,182.00 / $17,094.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.29 / $1,013.29 / $1,013.29
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$100.85 / $100.85 / $100.85
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$800.00 / $2,483.00 / $8,427.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.29 / $1,013.29 / $1,013.29
Priority Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$100.85 / $100.85 / $100.85
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$726.02 / $867.26 / $867.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,468.00 / $4,563.00 / $9,631.00