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Arizona rates for HCPCS 63688

Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $3,090.30 / $5,623.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $1,348.96 / $1,995.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.40 / $489.78 / $6,309.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $4,073.80 / $7,244.36